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New Patient Form

Use one of the options below to fill out our New Patient Form if your pet is new to Fayette Veterinary Medical Center.

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 Fayette Veterinary Medical Center to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Fayette Veterinary Medical Center 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 Fayette Veterinary Medical Center.

New Patients Welcome

Fayette Veterinary Medical Center is accepting new patients! Our experienced vets are passionate about the health of Fayetteville companion animals. Get in touch today to book your pet's first appointment.

(770) 460-0090