Mon – Fri: 8 AM – 6 PM
Sat: Hours vary. Please call before stopping in.

Sunday Closed

5049 Upper 141st Street West

Apple Valley MN 55124

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Thank you for booking your appointment with East Valley Animal Clinic; we are excited to meet you and your pet soon! To complete your booking and ensure a smooth experience, please complete our new client intake form before you arrive so that we can familiarize our team with you, your pet, your pet’s medical history, and visit needs. This will ensure a quick check-in and productive visit.

If you have any questions or issues, please contact our team at 952-423-6800.

New Client Intake Form

"*" indicates required fields

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Daytime Phone*

Evening Phone*

Email*

Pet's Name*

Age: Years, Months

Type of Pet*

Breed*

Fur Color of Pet

Sex*

Male

Female

Neutered/Spayed

Neutered

Spayed

Neither

Are your pets vaccines current?

Yes

Do you have your pets medical records?

Yes

May we request a transfer of records>?

Yes

Name of former Veterinary Practice

Medical records at another veterinary practice?

Yes

Would you like us to call you for your appointment?

Yes

Reasons of conditions that prompted your visit?

Please list any additional pets here

How Did You Hear About Us?*

Please Specify*

Promotion Code*

Comments

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Address:

5049 Upper 141st Street West
Apple Valley MN 55124

Email: eastvalleyanimalclinic@frontiernet.net

Phone: 952-423-6800

Fax: 651-846-6188

Hours:

Mon – Fri: 8 AM – 6 PM
Sat: Hours vary. Please call before stopping in.

Sunday Closed

Send Us a Message

Name*
Email*
Message
How Did You Hear About Us?*
Please Specify*
Promotion Code*
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