New Client Registration Form

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together. Please complete this from as fully as possible prior to your first appointment which will help expedite the registration process and give us valuable insight in providing optimal care for your pet(s). The required sections have a red * asterisk. Please note that we do not sell your information to any third party. Please refer to our privacy policy at the bottom of our web site for further information.

Owner's Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Mobile Phone*
Business Phone
Email*
Reminders/Communication Preferences*
- Phone Call
- Text
- Email
Please check all that apply for your communication preferences.
Co-Owner's Information
Name
First Last
Phone
Email
Pet Information
Pet's Name*
Species*
If you selected "Other" species, please specify below.
Breed*
For example, Holland Lop rabbit.
Sex*
Date of Birth or Approximate Age*
If you are unsure of the age of your pet, how long have you owned them?
Colour*
What food does your pet eat?*
Please specify the brand and size of main diet if possible.
Special Identification (tattoo, microchip, etc.)
Previous Veterinary Practice (if any)
Previous Veterinarian (if any)
Date of Last Vaccines (if known)
Date Format: MM slash DD slash YYYY
What vaccines were given at this time?
Is your pet on any medication or supplement?
- Yes
- No
If Yes, please list the medication or supplement below.
Does your pet have allergies or drug reactions?
- Yes
- No
If Yes, please list the allergies and reactions below.
Are there any current or past medical conditions of which we should be aware?
- Yes
- No
If Yes, please comment on the condition(s) and indicate if they are current or past conditions.
Please use the following box to give us any other relevant information about your pet.
How Did You Find Out About Our Practice?
How did you find out about our practice?*
- Clinic Location/Clinic Sign
- Personal Referral
- Professional Referral (another clinic)
- Internet Search
- Our Website
- Yellow Pages
- Other
If Personal Referral, which clinic and/or person can we thank for this referral?*
If Other, please specify:
Consent Forms
Our Personal Information Policy*
I agree to the Personal Information Policy.
I understand that the Axelson Veterinary Professional Corporation, operating as The Links Road Animal & Bird Clinic, has a Personal Information Policy in accordance with requirements of the Personal Information Protection and Electronic Documents Act.

By checking the box below, I am consenting to the collection, use and disclosure of my personal information in accordance with the purposes set out in the policy, which include the following:
• Maintaining complete and accurate client files, and complying with the requirements of the College of Veterinarians of Ontario, the Veterinarians Act and regulations under the Act;
• Providing goods and services to veterinary clients, including contacting clients to schedule appointments and follow up on patient treatment, billing for goods and services and notifying clients about new services and promotional offers; and
• Communicating and working with third parties providing veterinary medical or other services to clients, including other veterinary facilities and insurance companies which may pay for all or part of the cost of such services.

I understand that:
• My personal information will not be used or disclosed for purposes other than those for which it was collected, except with my consent, or except where the use or disclosure is required by law;
• I have the right to view my personal information and have it amended, if inaccurate or incomplete; and
• A copy of the Policy will be provided on request.
Our Photo Release Policy*
- I agree to and accept the Photo Release Consent.
- No, I do not consent.
I hereby grant my expressed consent for The Links Road Animal & Bird Clinic to post and exhibit photographs, videos and/or likenesses of the above-named pet. I hereby grant The Links Road Animal & Bird Clinic the right and permission to use, re-use, publish and re-publish images of my pet in the following formats: • Publications (newsletters, brochures, projects, etc.) • Press/media releases (online and printed articles and announcements) • Advertising materials • Our Website • Social media platforms (Facebook, Twitter, Instagram etc.) By signing this consent, I acknowledge that, for valuable consideration, I hereby release and forever discharge The Links Road Animal & Bird Clinic and the owners and employees from and against any and all claims, damages or suits which may arise from the use of the photographs, videos or likenesses for The Links Road Animal & Bird Clinic, including, but not limited to, the exhibition of the above-named pet’s photograph or likeness or publication of the pet’s name.
Thank you for registering with us!

If you would like to request an appointment for your animal, please contact us at 416-223-1165 or fill out the "Make An Appointment" form and we will be in touch with you to schedule and confirm your appointment.

New Client Registration Form

Owner's Information

Co-Owner's Information

Pet Information

How Did You Find Out About Our Practice?

Consent Forms

Ready to Make An Appointment?

Contact Us

Our Location

Hours

Emergency Hours: