New Client Registration

Please complete the form below before your appointment. 

Allied Vet Care -New Client Registration Form

We want to know about your pet’s previous medical history so we can provide the best, most appropriate care. You can help by providing previous records for us to review in advance of the appointment. Just ask your previous veterinarian to fax the records to 703-997-0436 or e-mail them to [email protected].

Appointment Request

Name(Required)
Address(Required)
Date of Birth(Required)
What is your preferred method of contact for general communication?(Required)
What day works best for your appointment? (please select two)(Required)
What time of the day do you prefer?(Required)

Pet Information

Species(Required)
Sex(Required)
Drop files here or
Max. file size: 50 MB, Max. files: 5.

    Payment Policy and Authorization

    Date(Required)
    This field is for validation purposes and should be left unchanged.
    Previous Records

    We want to know about your pet’s previous medical history so we can provide the best, most appropriate care.  You can help by providing previous records for us to review in advance of the appointment.  Just ask your previous veterinarian to fax the records to 703-997-0436 or e-mail them to [email protected].