New Clients | Join Our 'Ohana — Garden Island Veterinary Medicine

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Three dogs sitting in the back of an open-top jeep with a scenic background. Mobile veterinarian on Kauai. Wellness, holistic, preventive care, acupuncture, euthanasia.

Please fill out our new client/patient form prior to your appointment:

Client Name *

First Name

Last Name

Phone *

(###)

###

####

Email *

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Previous Veterinary Hospital:

Pet Name *

Species: *

Dog

Cat

Other

Sex: *

Male

Female

Spayed/Neutered: *

Yes

No

Age/DOB: *

Breed: *

Color/Markings: *

Approximate Weight of your Pet: *

Are Vaccinations Current? *

Yes

No

Unknown

Additional comments/notes

Please include any relevant historical information and the reason for your visit:

Additional Pets:

Please provide information about any other pets in your household.

Mahalo!

You have been added to our client list. To maximize our visit, please have your pet’s records sent to gardenislandvetmed@gmail.com

Happy brown dog sitting on rocky ground. Mobile veterinarian on Kauai. Wellness, holistic, preventive care, acupuncture, euthanasia.

Dog standing on a sandy beach on Kauai with cliffs in the background. Mobile veterinarian on Kauai. Wellness, holistic, preventive care, acupuncture, euthanasia.