31896 Plaza Dr Suite C-1, San Juan Capistrano, CA 92675 US
    949-201-4100

New Patient Form

Please fill out our New Patient Form using one of the options below if your pet is a new patient at Veterinary Medical And Surgical Group–OC (VMSG-OC) in Orange County.

OPTION 1
Complete Online

Complete and submit the online form below.

OPTION 2
Print & Complete

Bring the completed form with you to our hospital.

Download Form

OPTION 3
Complete on Arrival

If you prefer, complete the form when you get to our hospital.

New Patient Form

Please provide us with the following information. 

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

By listing your primary care veterinarian above, you are authorizing Veterinary Medical And Surgical Group–OC (VMSG-OC) to release patient information to the primary care hospital or
veterinarian.
By submitting this form, I hereby authorize Veterinary Medical And Surgical Group–OC (VMSG-OC) to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I authorize Veterinary Medical And Surgical Group–OC (VMSG-OC) to render the care and provide the supplies and medications necessary, knowing that in some cases certain drugs may be used off-label. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Veterinary Medical And Surgical Group–OC (VMSG-OC).

New Patients Welcome

Veterinary Medical And Surgical Group–OC (VMSG-OC) accepts new clients to our specialty services and 24/7 emergency services.

Contact Us

949-201-4100