Haven Animal Hospital

7775 South Rainbow Blvd., Ste 160
Las Vegas, NV 89139



New Client Check In

If you would like to make an appointment, you can assist us to expedite your check in by submitting this form.

Thank you for your cooporation in letting us assist you.

New Client Form - Submit Online

Name & Email (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
State / Province (required)
Zip / Postal Code (required)
Daytime Phone (required)
Phone TypePhone Number (required)
Evening Phone (required)
Phone TypePhone Number (required)
E-Mail Address :
Pet's Name (required)

Age: Years, Months

Type of Pet (required) :

Sex: (required)


Are your pets vaccines current?
Do you have pets medical records?
Medical records at another veterinary Practice?

Name of Former Veterinary Practice

May we request a transfer of records?

Would you like us to call you for your appointment
Reasons or conditions that prompted your visit?

Special requests or conditions?

Please list any additional pets here

Please Read
I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Haven Animal Hospital and that charges are due and payable at the time of service.
I have read this statement and -
I Agree
I Disagree

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7775 South Rainbow Blvd. Suite

Las Vegas, NV 89139

Call (702) 260-6260