Register as a New Client

If you're planning on coming to see us at the Worth Street Veterinary Center, please take a moment to register by submitting the below form. This will shorten your waiting time and further improve your experience at the hospital. If you'd prefer to fill out our new client form by hand, you may print it out and bring it in at your first visit.

Print New Client Form

Register Online

Owner Name

Address

Apartment

City

State

Zip

Primary Phone

Secondary Phone

Occupation

E-Mail Address

Pet’s Name

Pet Breed

Pet’s Date of Birth

Coat Color

Pet Gender Male Female

Spayed/Neutered No Yes

How did you hear about our clinic?

Previous veterinary hospital information (Please provide the name and phone number so that we can obtain your pet's medical records.)

Additional information we should know about your pet

All fees are due at the time services are rendered. The Worth Street Veterinary Center accepts cash, checks and credit cards for your convenience. We do not offer deferred payment plans or bartering. By typing your name in the following box and clicking "agree," you acknowledge and understand the above statement.

Agree I Agree

Security Code

Please enter the code

Register as a New Client

Register Online

We will contact you after processing your information. Thank you for choosing Worth Street Veterinary Center!