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New Patient Form

If this is your pet's first time at Rockland Veterinary please complete our New Patient Form via any one of the following methods.

Option 1

Complete Online

Fill out and submit the following online form.

Option 2

Complete on Arrival

If you wish, complete the form at your appointment.

New Patient Form

Please fill out the new patient form for the hospital location of your appointment.


Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Rockland Veterinary to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Rockland Veterinary to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Rockland Veterinary.

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Rockland Veterinary to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Rockland Veterinary to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Rockland Veterinary.

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Rockland Veterinary to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Rockland Veterinary to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Rockland Veterinary.

We are now accepting new patients!

At Rockland Veterinary we are passionate about animals and enjoy helping cats and dogs feel well. Contact our vets in Rockland County today to schedule your furry companion's first appointment! 

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