Start your journey in seconds

Please take a few moments to fill out our New Patient Form using one of the options below if your pet is a new patient at Animal Emergency Center.

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Multiple ways to fill out the new patient form

Complete Form

Complete and submit the online form below.

Complete Form

Print & Complete

Please download and complete the patient form before your visit to help us serve you more efficiently.

Complete on Arrival

If you prefer, fill out the form when you get to our hospital.

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Owner Information

Owner First Name *

Owner Last Name *

Phone Number *

Email *

Address *

City *

Zip Code *

Apt/Unit

County *

Spouse/Partner

Secondary Number

How did you learn about our practice? *

Frequently Asked Questions About Patient Forms

What our clients say

Erin D.

"This place is great. Friendly, helpful, and knowledgeable staff. They were there and willing to help us with a hawk that was injured on our street when no one else was!"

Book an Appointment at Emergency Vet Memphis, TN Hospital

New pets are always welcome at Emergency Vet Memphis, TN Hospital. Our friendly veterinary staff looks forward to providing our neighbors in Citrus Heights and surrounding communities with the veterinary care they need.

Book Online
Rottweiler Dog