New Patient Form

Online Form Submission

Please fill out the New Patient Form below and send to us online. Alternatively, you can fill out the form when you arrive for your first visit.

Client Information

New Patient Information

IMPORTANT: Payment is required at the time services are performed.
I understand I am financially responsible to Western Carolina Regional Animal Hospital & Veterinary Emergency Hospital for all charges incurred. I further agree in the event of non-payment to bear the cost of collection and/or court and legal fees should this be required.
By submitting this form, I agree to the above.

(828) 697-7767