New Client Form

Thank you for trusting SagePet Home Veterinary Care LLC ("SagePet") with your pet’s care. Please be as complete as possible with your responses to the following questions so that we can provide the best care for your pet.

Please note that our house call visit fee is $175 for the first pet and $95 for each additional pet seen. This includes travel to your home and a one hour in home consultation. For more information, please check out our FAQs.

"*" indicates required fields

Client contact information

Name*

First Last

Pronouns. Examples: she, he, they

Please include the name(s) and pronouns of any other co-owners if applicable

Address*

Street Address Address Line 2 City State ZIP Code

Phone Number*

Email*

Phone Number (owner #2)

Email (owner #2)

How did you hear about us? If a personal recommendation, whom may we thank?*

Pet information

For multiple pets, you can simply send additional pet information via email to info@thesagepet.com

Pet's name*

Species (i.e. cat, dog, rabbit, etc.)*

Breed*

Sex (male, female)*

Is your pet spayed or neutered?*

Yes

Approximate age or birthdate*

Has your pet ever had an adverse reaction to a medication or a vaccine? If so, please describe.*

What medications or supplements does your pet take currently?*

Has your pet had any significant medical problems in the past (hospitalizations, chronic medical problems, surgeries)?*

What questions or concerns do you have about your pet's health?*

What are your goals for your pet's care with Dr. B?*

Previous medical history

Please provide the name and contact information for any veterinary clinic your pet has been to recently so we may contact them for records. If your pet has not been seen previously, please just write none.*

We would love to see a photo of your beautiful pet, do you have one you could share?

Accepted file types: jpg, png, Max. file size: 50 MB.

If you have electronic copies of any of your pet's medical records, please upload them below.

Drop files here or

Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 50 MB, Max. files: 5.

Notifications and Patient Agreements

Thank you for reaching out to SagePet!

Dr. B is a one-woman show and does not have a receptionist or assistant. She will review your submission personally and reach out to you about next steps for scheduling. Please allow 1-2 business days for a response. Please reach us at info@thesagepet.con with any questions or concerns.

Phone

This field is for validation purposes and should be left unchanged.