Fox River Animal Hospital - Appleton, WI - New Client

Fox River Animal Hospital

2021 East Calumet Street
Appleton, WI 54915


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 cooperation in letting us assist you.

New Client

Owner's Name (required)
First Name (required)
Last Name (required)
2nd Owner's Name
First Name
Last Name
Address (required)
Street Address (required)
City (required)
State / Province (required)
Zip / Postal Code (required)
Owner 1 Phone Number (required)
Phone TypePhone Number (required)
Owner 2 Phone Number
Phone TypePhone Number
E-Mail Address (required) :
Do you currently have an appointment scheduled with us? If so, what is the date and time?

We occasionally like to make our patients internet famous:) Do you consent to your pet's picture for entertainment or educational purposes on Social Media (Facebook, Instagram etc.)?

No thanks

How did you hear about us? (if someone referred you, please write their name in the box below.

Pet's Name (required)

Age in years and months or birthdate (required)

Type of Pet (required)


Breed and color: (required)

Sex: (required)




Are your pet(s) vaccines current?
Do you have your pet(s) medical records?
Medical records at another veterinary Practice?


Name of Former Veterinary Practice

Reasons or conditions that prompted your visit?

Please list any additional pets here (Name, age, sex, species, breed and color)

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