New Patients

Want to skip the clipboard? Fill out the form below before your first visit and we’ll have everything ready when you arrive.

What to Expect

One Form for Everyone

Fill out your information once, then add each pet you’re bringing in. You can register multiple pets in a single submission.

Arrive a Few Minutes Early

Even if you’ve submitted the form online, plan to arrive 5–10 minutes before your appointment to get settled in.

Questions? Just Call

If you’re unsure about anything, give us a call at (260) 665-2090 and we’ll be happy to help.

New Client & Patient Registration

Owner

Pets

Finish

Owner / Client Information

First Name *

Last Name *

Phone *

Email *

Street Address (optional)

City

State

ZIP

Partner / Spouse Name (optional)

Partner / Spouse Phone (optional)

Pet / Patient Information

Almost Done!

How did you hear about us? (optional)

By submitting this form, you confirm that the information provided is accurate and authorize Beechwood Veterinary Clinic to contact you regarding your registration. Your information will be kept confidential.