Welcome to Bel-Aire Veterinary Hospital. Your Veterinarians in Greensboro, NC. Call us at (336) 665-1286

New Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet’s before your visit.

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New Client Form

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

What is the microchip number?

Do you have a second pet? *

Pet's 2 Name

Pet's 2 Species (dog, cat, etc.)

Pet's 2 Breed

Pet's 2 Age/Date of Birth

Pet's 2 Sex

Male
Neutered Male
Female
Spayed Female

Does your pet 2 have a microchip identification?

What is the microchip number for pet 2?

Payment is due in full at the time that services are performed. If being admitted into the hospital, we cannot begin the care of your Pet until you have confirmed your desire to do so by 1) signing the client consent & estimate form, and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your Pet. We accept Cash, Visa, MasterCard, Discover, and CareCredit payments. We neither extend credit, nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

Message

Book Appointment

Our goal at Bel-Aire Veterinary Hospital in Greensboro, NC, is to make both people and their pets feel at home. We advance veterinary medicine to new heights. We pay close attention to the demands of your pets, thus it’s important that we comprehend your worries. Please use our online system to book an appointment.

Book Appointment

We Proudly Serve The Pets of Greensboro, NC, And Beyond

It is our mission to partner with our clients to nurture and preserve the human-animal bond by providing compassionate, expert, and affordable veterinary care from your pet’s first adventure throughout a long and healthy life. We proudly serve the pets of Greensboro, High Point, Winston Salem, Oak Ridge, Summerfield, Madison, Eden, Stokesdale, Archdale, Kernersville, Reidsville, NC and surrounding areas.

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