Cottage Grove Veterinary Clinic

Cottage Grove Veterinary Clinic - Cottage Grove, OR - New Client

1221 E. Main St.

Cottage Grove, OR 97424

We are currently seeing patients by curbside pick-up for appointments.

No clients will be permitted inside our clinic unless there are exceptions to special cases or saying a final goodbye to your beloved pet.

We understand this can be stressful for all concerned, including your pets and our staff.

We appreciate your patience as we safely navigate through these guidelines and challenging times while working together with you to provide and maintain a safe environment.

1221 E. Main St.
Cottage Grove, OR 97424

(541)942-9181

www.cgvetclinic.com

New Client Check In

If you would like to make an appointment, you can assist us to expedite your check in by submitting this form.

Thank you for your cooperation in letting us assist you.

New Client

Name *(required)*

First Name (required)	Last Name (required)

Address (required)
Street Address (required)

City (required) ,	State / Province (required)	Zip / Postal Code (required)

Daytime Phone (required)
Phone Type	Phone Number (required)

Evening Phone (required)
Phone Type	Phone Number (required)

E-Mail Address :

Pet's Name (required)

Age: Years, Months

Type of Pet (required) :

Breed:

Sex: (required)

Male
Female

Neutered/Spayed

Neutered
Spayed

Are your pets vaccines current?

Do you have pets medical records?

Medical records at another veterinary Practice?

Yes
No

Name of Former Veterinary Practice

May we request a transfer of records?

Yes
No

Would you like us to call you for your appointment

Reasons or conditions that prompted your visit? (required)

Special requests or conditions?

Please list any additional pets here

Verify the reCAPTCHA:

* Our office has a short appointment day every other Thursday. We will still be staffed and open for supply/medication pickups until 6pm

If you have an emergency outside of our regular business hours, we recommend that you contact the local emergency hospital:

Emergency Veterinary Care | Emergency Veterinary Hospital (emergencyvethosp.com)