New Client Registration Form

Client Information

Owner's Name *

First

Last

Phone Number *

Is there a co-owner?

Address *

Address Line 1

City

State

Zip Code

Email *

Confirm Email

Would You Like Email Reminders?

Pet's Information

Pet's Name *

Species *

Breed *

Color *

Age *

Birthday//

Sex (copy) *

Spayed/Neutered *

Microchipped? *

Previous Pet Information

Registering a 2nd pet? *

Upload Previous Records Below

File Upload

Click or drag a file to this area to upload.

Consent Form

By signing below, I certify that I am the owner of the animal described above. I acknowledge that I may be charged a $35 no-show fee for any missed appointments without a 24 hour notice of cancelation, and am aware that if I am more than 10 minutes late for my appointment, it will be forfeited and I will be rescheduled at the clinic's next availability.

Signature *

Palo Verde Pet Clinic

Prevention is the best medicine

Palo Verde Pet Clinic is our first animal clinic in Yuma focused solely on pet wellness and preventive care. If you’re looking for an experienced veterinary staff and outstanding support for your beloved pet, we’re here for you!

Palo Verde Pet Clinic - Veterinary Clinic in Yuma, AZ

[email protected]

3325 S Avenue 8E
Suites B3 & B4
Yuma, AZ 85365
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928.224.3131