URGENT NOTICE: Our ER is experiencing a high volume of cases. Please call ahead so we can talk you through your pet’s situation and prepare for your arrival.

New Pet Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

Get Started

Online Forms

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 716-646-4023 for a faster response.

We are happy to welcome your new pet! Are you... *

New client with a new pet
Current client with a new pet

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone Number *

Home Phone Number (Landline)

Work Number

Email *

Name of spouse, partner, or other person you would like on the account. Please include name, cell phone, or other contact information for this person.

How did you hear about us?

If you were referred by a family or friend, please specify name for a referral gift certificate.

Date of appointment at the Village Veterinary Clinic of Hamburg *

Time of appointment at the Village Veterinary Clinic of Hamburg *

Pet Information

Name *

Breed *

Species *

Date of Birth *

Sex *

Male
Neutered Male
Female
Neutered Female

Are there any known allergies in your household- both human or pet? Food? Medication? We give treats in our exams, such as cheese and peanut butter. Please let us know of any allergies prior to exposure. *

All payments are due at the time of services. A deposit is due if a patient is hospitalized. The remaining balance will be due upon discharge. We accept Visa, Mastercard, Discover, Care Credit, or Cash. NO CHECKS.

Please download our FREE pet app, PetDesk!

Signature *

Clear Signature

New Pet Form

Online Forms

Pet Information

Make a Veterinary Appointment
Hamburg, New York.

Our Contact Information!

Location

Contact Information

Hours

We're here for you!Please complete the form below, and a member of our team will get back to you as quickly as possible.

We're here for you!Please complete the form below, and a member of our team will get back to you as quickly as possible.