Albert Lea Veterinary Clinic,LLC

401 Saint Thomas Avenue
Albert Lea, MN 56007-3737

(507)373-8161

www.albertleavet.com

New Client /Patient Forms

A deposit for the first exam fee ($51) may be required to book your first appointment as this reduces no-shows and last-minute cancellations that impact our ability to care for current patients. This is refundable only if you cancel with at least 48 hours notice. Future appointments do not currently require a deposit.

A staff member will reach out to you to schedule as soon as they've set you up in our system, usually the same business day.

Thanks for choosing Albert Lea Veterinary Clinic!



New Client/Patient

Reason For Visit (required)

Do you have an appointment scheduled? (required)
Yes
No-Please call me to schedule
Prior to your appointment, please contact your previous veterinarian if you do not have copies of relevant medical history and vaccination records.
Providing records in advance of your visit can significantly speed up check in and your visit - they may be emailed to recordsalvc91@gmail.com or dropped off in person.
Name (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
,		State / Province (required)
Zip / Postal Code (required)
Phone Number (required)
Phone TypePhone Number (required)
E-Mail Address :
Pet's Name (required)

Birthdate (or best guess): (required)

Species of Pet (required)

Canine
Feline
Avian
Exotic
Other


Breed (or best guess): (required)

Sex: (required)

Male Intact
Male Altered
Female Intact
Female Altered
Not sure


Current Diet (required)

Do you think your pet has any food allergies or intolerances?
Yes
No
Not Sure
Please list any additional pets here

Do you feel your pet is aggressive? (required)
No, never
With strangers or new people
With other animals
I'm afraid of my pet
Does your pet engage in behaviors that annoy or concern you? (required)
Yes
No
My pet is AWESOME!
Is your pet on heartworm prevention? (required)
Yes
No
Not sure
Does your pet regularly get flea & tick prevention? (required)
Yes
No
Not sure
Please list any other current medications

Please READ BELOW CAREFULLY and check any problems your pet is currently experiencing.

General
Increased drinking or urination?
Gastrointestinal
Lethargy or tiredness
Vomiting Diarrhea or loss of appetite
Musculoskeletal
Limping
Difficulty rising or with using stairs
Skin/Ears
Hairloss or itching?
Fleas or ticks?
Wounds or sores?
New masses or lumps?
Shaking head or scratching ears?
Eyes
Discharge, redness, rubbing or squinting?
Respiratory
Coughing, sneezing, or nasal discharge?
Difficult/labored breathing?
If you answered YES to ANY of the above questions, please explain - what's going on, when did it start, is it getting worse/better, etc:

I hereby entrust my pet(s) medical care to the Veterinarians and Staff of Albert Lea Veterinary Clinic. I have also been made aware of, and agree to, the following ALVC policies
1. All payments are due in full at the time services are rendered.
2. For their safety, all pets are required to be on a leash or in a carrier at all times.
3. All pets will, at all times, be treated with the care and compassion we would treat our own family members.
4. Photos of pets may be taken while in the practice, and may occasionally be used for educational purposes or posted on social media. No images or information will be used that would identify you personally without your permission.
We understand life's events are not always in our control however, in order to provide timely,reliable service to our patients,
frequent last-minute cancellation/rescheduling may require pre-payment for future scheduling or discontinuation of patient status.
I understand and agree (required)
Yes

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Testimonials

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'Dr. Smith has cared for our pets for nearly 14 years. We have appreciated his kindness and excellent care of each of our fur babies. Each member of the office is also wonderful. We are very fortunate to have this clinic in our town. ~Heidi S.

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Testimonials

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'Dr. Smith has cared for our pets for nearly 14 years. We have appreciated his kindness and excellent care of each of our fur babies. Each member of the office is also wonderful. We are very fortunate to have this clinic in our town. ~Heidi S.

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