Call 406 586 7387 (PETS)
Fax 406 388 2275 (BARK)

careteam@arkveterinarypractice.com

 Client Registration

 GET IN TOUCH

 Call us for your appointment today                                                (406) 586-7387

1740 East Baseline Rd

Belgrade, MT 59714

Call 406 586 7387 (PETS)
Fax 406 388 2275 (BARK)

careteam@arkveterinarypractice.com

7:45 am - 6:00 pm Monday-Friday
By appointment only

Available 24/7 for client emergencies

Thank you for choosing Ark Veterinary Practice for your animals’ healthcare needs. We care for all species here so please don’t be alarmed if alpacas or parrots arrive! As you are giving us the opportunity to care for your pet(s) we want to make sure that we start off communication in the best way possible by getting to know each other and learning each other’s expectations. Please take a few minutes to complete this form for us so that we can best serve you. If you have questions please don’t hesitate to ask. We are here to help make your experience as enjoyable as possible. We look forward to working with you as we partner with you in the care of your loved ones.

Owner’s Name(s):___________________________________________________________________________

Address: ______________________________________________City:_______ State:______ Zip: __________

Home Phone: _____________ Cell Phone/Text: ________________ E-mail: ____________________________

Employer: ______________________________Work Phone: ________________________________________

Is it OK to call you/them at work (please circle):          yes             no            emergency only

Please star * the method of contact you would prefer and circle the time:   any   am only   pm only   __________

 

Co-Owner’s/Guardian’s Name(s): ________________________________________________________________

Address: ______________________________________________City:_______ State:______ Zip: ___________

Home Phone: _____________ Cell Phone/Text: ________________ E-mail: _____________________________

Employer: ______________________________Work Phone: _________________________________________

Is it OK to call you/them at work (please circle):          yes             no            emergency only

Please star * the method of contact you would prefer and circle the time:   any   am only   pm only   __________

Emergency Contact: __________________________________Phone: __________________________________

 

How did you hear about Ark Veterinary Practice (please circle)?

Google  .  Yelp  .   Facebook  .  Phone Book Ad  .  Yellow Pages .  Neighbor  .  Drove By  .   Online   .  Personal Referral  

Whom may we thank? ________________________________________________________________________

 

What experiences have you had in the past with veterinarians and what 3 things are most important to you?

All positive    Mostly positive    Hit and Miss   Some negative   All Negative So Far

 

Convenience . Attention to Detail . Efficient . Education/Learning . Customer Service . Good Communication . Fair Price . Home Delivery

 

Compassion . Multiple Patient Discounts . House Calls . After Hours Service . Child Friendly . Tech Savvy . Gentle & Calm . Online Pharmacy 

 

Do we have your permission to contact your previous veterinarian(s) for medical records?      Yes     No

Name of previous veterinarian(s), clinic name, town, state, phone number:________________________________

 

 WHERE TO FIND US