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New Client Form

Welcome to Governor Animal Clinic—we’re excited to meet you and your pet. Completing the New Client Form before your first visit allows our team to prepare in advance and provide a smoother, more personalized experience from the moment you walk through our doors.

Child and cat interacting

Fluffy cat, toy balls

How to Complete the Form

Please take a few minutes to fill out all required sections of the form prior to your appointment. Be sure to include:

Your contact information
Your pet’s age, breed, and medical history
Current medications or health concerns
Previous veterinary records, if available

If you have multiple pets, submit a separate form for each one so we can keep their records complete and organized.

Complete Your New Client Form

Completing your New Client Form in advance helps us focus on what matters most—your pet’s health and comfort. Please submit your form today to get started with Governor Animal Clinic.

Client Information

Name *

First

Last

Email *

Medical reminders and appointment confirmations may be sent via email. Please ensure your email address is entered correctly and update your spam or safe sender settings to allow messages from info@governoranimalclinic.com

Primary Phone *

Do you agree to receive text messages from Governor Animal Clinic? *

I agree

By checking this box, you consent to receive informational and/or promotional text messages from Governor Animal Clinic at the number provided, including messages sent by the autodialer. Consent is not a condition of purchase. Message & data rates may apply. Message frequency varies. Unsubscribe at any time by replying STOP. Reply HELP for help. Privacy Policy.

Secondary Phone

Please select which phone number you would like us to use for text messages and appointment communications. *

Primary Phone
Secondary Phone

Employer/Occupation

Work Phone

Would you like to add a Spouse or Secondary Owner? *

Yes
No

Spouse/Secondary Owner Name

First

Last

Spouse/Secondary Owner Email

Spouse/Secondary Owner Primary Phone

Spouse/Secondary Owner Secondary Phone

Spouse/Secondary Owner Employer/Occupation

Spouse/Secondary Owner Work Phone

Children’s Names:

Home Address *

Address Line 1

City

State

Zip Code

Pet Information

Pet's Name *

Species (dog, cat, etc.) *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Breed/Description *

Do you have a second pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Breed/Description *

Do you have a third pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Breed/Description *

Do you have a fourth pet? *

Yes
No

Pet's Name *

Age/Date of Birth *

Species (dog, cat, etc.) *

Sex *

Male
Neutered Male
Female
Spayed Female

Breed/Description *

Have any of your pets shown signs of aggression or fear? Please list pet’s name(s):

How did you hear about us? (Please be specific)

Appointment cancellations must be made at least 24 hours in advance. *

I have read, understand, and agree to the above statement.

Written estimates will be provided upon request. All fees are due at the time services are rendered. We accept cash, personal checks, and major credit cards. There will be a $25.00 service charge for any checks returned unpaid. *

I have read, understand, and agree to the above statement.

Although we do not offer billing services, we accept Mastercard, Visa, Discover, and American Express. Please ask us about CareCredit if you wish to arrange financing. *

I have read, understand, and agree to the above statement.

Should this account become delinquent, I understand that I am responsible for any and all legal fees, court costs, and collection charges involved as a result of any collection activity. *

I have read, understand, and agree to the above statement.

Hospital personnel are not here 24 hours a day. Patient care may be provided on a limited basis during overnight hours only as deemed necessary by the attending veterinarian. *

I have read, understand, and agree to the above statement.

I give consent for Governor Animal Clinic to release medical records of my pets when requested (i.e. emergency clinic, veterinary hospital, pet insurance agency, etc.). *

I have read, understand, and agree to the above statement.

Species messages Primary

Signature of owner/responsible agent for pet(s) *

Clear Signature

Date *

Phone

If your pet needs immediate care or you have urgent questions, please call us directly at (858) 453-6312. Online forms are not monitored for emergency situations.

Ready for a visit?

Governor Animal Clinic is a full-service veterinary clinic in San Diego providing compassionate care for dogs and cats. We offer wellness exams, surgery, diagnostics, and Fear Free visits for pets in University City, La Jolla, Clairemont, and nearby areas.

Book Appointment

Have a question?

Reach out to our team by completing our online form, and we’ll respond to your request promptly.

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Contact Us

Phone: (858) 453-6312
Text: (858) 453-6312
Email: info@governoranimalclinic.com

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Location

3240 Governor Dr
San Diego, CA 92122

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Hours

Monday–Friday: 7:30 AM – 5:30 PM
Saturday: 8:00 AM – 12:30 PM
Sunday: Closed

Name *

First

Last

Email *

Phone

Do you agree to receive text messages from Governor Animal Clinic? *

I agree

By checking this box, you consent to receive informational and/or promotional text messages from Governor Animal Clinic at the number provided, including messages sent by the autodialer. Consent is not a condition of purchase. Message & data rates may apply. Message frequency varies. Unsubscribe at any time by replying STOP. Reply HELP for help. Privacy Policy.

How can we help you? *

Phone

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