New Client Intake Form Please enable JavaScript in your browser to complete this form.Primary Owner's Name (must be a legal adult) *FirstLastAddress *FirstMiddleLastPhone Number *Email *Driver's License/ State ID NumberSecondary Owner/Emergency Contact Information *FirstLastPrevious Veterinary ClinicName & Breed of Your Pet(s) *I am aware that this office DOES NOT BILL and that I am always responsible for payment at the time services are rendered.I hereby authorize the veterinarians of the Bird & Exotic Clinic of Seattle to examine, prescribe for and treat my pet(s). I assume responsibility for all charges incurred in the care of my pet(s). *FirstLastSubmit