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New Patient Form

We want your visit to our animal hospital to be as easy and convenient as possible. Please take a couple of moments to fill in and submit our New Patient Form online. Or, you can complete the form when you arrive at our hospital.

Option 1

Complete Online

Complete and submit the online form below.

Option 2

Complete on Arrival

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

New Patient Form

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Pacific & Santa Cruz Veterinary Specialists to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Pacific & Santa Cruz Veterinary Specialists 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 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 Pacific & Santa Cruz Veterinary Specialists.

New Patients Welcome

Pacific & Santa Cruz Veterinary Specialists is always accepting new patients! Our experienced vets are passionate about restoring good health to Santa Cruz companion animals. We are open 24/7 to provide your pet with care, whenever they need us.

Contact Us

Contact (831) 475-5400