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Veterinary New Patient Intake Template

Start every veterinary relationship on the right foot. This new patient intake form collects owner contact details, complete pet information, vaccination records, medical history, and the reason for the visit — all before the appointment even begins. Replace paper clipboards with a clean digital form your clients can complete from home.

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Free for non-commercial projects, with unlimited forms and responses.

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The starting point

About this template

A veterinary new patient intake form is the first touchpoint between a pet owner and your practice. Collecting the right information up front — species, breed, age, vaccination status, and current medications — lets your team prepare before the appointment rather than scrambling through questions at the front desk. It also establishes a documented record from day one.

More about this template

Paper forms are slow, hard to read, and require manual data entry into your practice management system. A digital intake form eliminates that bottleneck. Clients fill it out at home on their phone, and the data arrives in your inbox formatted and ready to act on. For practices seeing 30 or more new patients a month, this alone saves hours of administrative work.

formformform makes it easy to customize this template for your specific practice — add fields for insurance provider, referral source, or emergency contact without touching a line of code. Forms are embeddable on your clinic website or shareable via a direct link sent in your new patient welcome email.

13 fields to make your own8 required in this starting form

Make it fit your workflow.

Use your own copy to change labels, remove questions and add the details you need. Try the preview alongside this guide to see what respondents will be asked.

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The questions, explained

Fields in this template

Review the starting questions and choices. You can change them in your own copy.

  • Short answerRequired

    Owner Full Name

    Jane Smith

  • Email addressRequired

    Email Address

    jane@example.com

  • Phone numberRequired

    Phone Number

    (555) 123-4567

  • Short answerRequired

    Pet Name

    Buddy

  • DropdownRequired

    Species

    6 choices
    • Dog
    • Cat
    • Bird
    • Rabbit
    • Reptile
    • Other
  • Short answerOptional

    Breed

    Labrador Retriever

  • DateOptional

    Date of Birth

  • Single choiceRequired

    Sex

    2 choices
    • Male
    • Female
  • Single choiceRequired

    Spayed / Neutered

    3 choices
    • Yes
    • No
    • Unknown
  • Long answerOptional

    Previous Medical History

    List any past illnesses, surgeries, or conditions.

  • Multiple choiceOptional

    Vaccinations Up To Date

    7 choices
    • Rabies
    • Distemper/Parvo (DHPP)
    • Bordetella
    • Leptospirosis
    • Feline Leukemia
    • FVRCP
    • Not sure / records unavailable
  • Long answerOptional

    Current Medications or Supplements

    Include dosage and frequency.

  • Long answerRequired

    Reason for Today's Visit

    Describe the primary concern or reason for this appointment.

Where it fits

Who uses this template

Suggested uses, and why this starting point can help. Adapt the questions to your own process.

Veterinary clinics

Use this as a starting point when you need the same essential information from each person. Review the questions against your process before sharing your copy. Review “Species” in particular and adapt it to the detail you need.

Animal hospitals

Use this as a starting point when you need the same essential information from each person. Review the questions against your process before sharing your copy. Review “Breed” in particular and adapt it to the detail you need.

Mobile veterinarians

Use this as a starting point when you need the same essential information from each person. Review the questions against your process before sharing your copy. Review “Date of Birth” in particular and adapt it to the detail you need.

Exotic animal practices

Collects tank size, water parameters, filtration type, and tankmate details for veterinary practices that treat fish and aquatic species.

Holistic pet wellness centers

Adds diet type, supplement use, and stress behavior fields to standard medical history for integrative or holistic veterinary practices.

University veterinary teaching hospitals

Includes fields for referring veterinarian, case complexity consent, and teaching participation acknowledgment alongside standard pet details.

Emergency animal clinics

Streamlines rapid intake by collecting chief complaint and current medications first, with full history fields for follow-up.

What's included

Species dropdown covering dogs, cats, birds, rabbits, reptiles, and more
Vaccination checklist for both canine and feline vaccines
Medical history and current medications fields
Sex and spayed/neutered status fields
Reason for visit section to prepare the veterinarian in advance
Instant email notification on submission
Mobile-friendly for clients completing on their phones
Unlimited submissions with no per-form fees

How to create a veterinary new patient intake

  1. 1

    Click 'Use this template' to open this intake form pre-built in formformform.

  2. 2

    Edit the species dropdown to add or remove options relevant to your practice (e.g., add 'Guinea Pig' or 'Ferret' for exotic clinics).

  3. 3

    Expand the vaccination checklist to include every vaccine your practice tracks.

  4. 4

    Add your clinic's logo and adjust colors to match your brand in the form settings.

  5. 5

    Set your notification email so completed forms arrive directly in your inbox or team inbox.

  6. 6

    Share the form link in your new patient welcome email or embed it on your website's 'New Patients' page.

Best practices for your veterinary new patient intake

Send the link before the appointment

include it in your new patient confirmation email so clients arrive with the form already completed.

Mark vaccination fields as optional

some new clients won't have records handy. Require what's truly essential and gather the rest during the visit.

Include a 'reason for visit' text field

a free-text description gives the vet context that a dropdown never can.

Ask for medication names and dosages separately

'current medications' buried in a general notes field leads to vague responses. A dedicated field gets specific answers.

Use the breed field as free text

breed dropdowns with hundreds of entries frustrate users. A short_text field is faster and more accurate.

Test the form on a mobile device

most pet owners will complete it on their phone while sitting in the car or waiting at home.

14 form ideas you can build with this template

Feline-Only Clinic Intake Form

Captures cat-specific details like indoor/outdoor status, litter box habits, and feline vaccine history for practices that see cats exclusively.

Avian Veterinary Intake Form

Collects species, subspecies, diet, cage environment, and wing-clipping history for birds brought to avian specialty vets.

Exotic Reptile Intake Form

Gathers enclosure temperature, humidity settings, feeding schedule, and substrate type alongside standard medical history for reptile patients.

Emergency Animal Hospital Intake

Streamlines rapid intake by collecting chief complaint and current medications first, with full history fields for follow-up.

Mobile Veterinarian Client Form

Sent via link before an at-home visit so the mobile vet arrives knowing the pet's history without carrying paper forms.

University Veterinary Teaching Hospital Intake

Includes fields for referring veterinarian, case complexity consent, and teaching participation acknowledgment alongside standard pet details.

Holistic Pet Wellness Intake Form

Adds diet type, supplement use, and stress behavior fields to standard medical history for integrative or holistic veterinary practices.

Rabbit and Small Mammal Intake Form

Captures housing type, hay and pellet diet details, and whether the rabbit is free-roaming or caged for small mammal specialists.

Low-Income Clinic New Patient Form

Includes a financial assistance program checkbox and sliding-scale eligibility questions alongside standard intake fields.

Multi-Pet Household Intake Form

Allows owners to register multiple pets in a single submission by listing all animals in the household and their individual histories.

Senior Pet Wellness Intake Form

Emphasizes age-related health screening questions including mobility, cognitive changes, appetite shifts, and joint health for geriatric patients.

Shelter Veterinary Intake Form

Adapted for animal shelters to document stray intake condition, estimated age, found location, and immediate health assessment needs.

Aquatic Animal Intake Form

Collects tank size, water parameters, filtration type, and tankmate details for veterinary practices that treat fish and aquatic species.

Military Working Dog Intake Form

Includes handler contact information, service branch, deployment history exposure, and duty assignment alongside standard medical history.

Frequently asked questions

Can I customize the species list for an exotic animal practice?

Yes. The species dropdown is fully editable. You can add guinea pigs, ferrets, hedgehogs, fish, or any species your practice sees, and remove options that aren't relevant.

How does the form handle vaccination records?

The template includes a checkbox field listing common canine and feline vaccines. You can customize the list to match your practice's vaccine protocols. Clients check off what's current; the full records can be brought in at the appointment.

Can clients fill this out on a mobile phone?

Yes. All formformform forms are fully responsive and work on any device. Most pet owners prefer to fill out intake forms on their phone before arriving at the clinic.

Is there a way to receive submissions directly in my practice management software?

formformform sends submissions to your notification email. From there you can manually enter the data, or use a tool like Zapier to route submissions directly to software like Vetspire, IDEXX, or AVImark.

What if a client doesn't know their pet's date of birth?

The date of birth field is set as optional. Clients who adopted a rescue or stray often don't have this information. You can note the approximate year during the visit.

Can I add a field for pet insurance information?

Absolutely. You can add a short_text field for insurance provider name and policy number. This is especially useful for practices that file claims on behalf of clients.

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Free for non-commercial projects, with unlimited forms and responses.

Use this template