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) *Time and Date of Your Pet's Existing Appointment *Filling out this form does not guarantee an appointment. If your pet does not have an existing appointment, please call the clinic to schedule one before completing this form. I am aware that this office DOES NOT BILL and that I am always responsible for payment at the time services are rendered.I understand the clinic's 10 minute late policy and the need to reschedule or pay a late fee if I am more than 10 minutes late to my 30 minute appointmentI understand the clinic's COVID and mask policy and will reschedule/cancel my appointment if I am feeling sick/or unwellI 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