New Pet Form

Welcome to Chateau Dog & Cat Hospital!
Help us get to know your new pet by completing the form below!

New Pet Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 812-477-8866 for a faster response.

Thank you for your continued patronage with Chateau Dog and Cat Hospital and congratulations on your new pet! In the fields below, please tell us about your pet so we may get them added to your profile.

Please note: Any field with an asterisk (*) is required.

Owner Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone *

Secondary Phone

Email *

Pet Information

Pet's Name *

Species *

Dog
Cat

Breed *

Color *

Age/Date of Birth *

Sex

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification?

Yes
No

Microchip Number

If known

How long have you owned this pet?

Owner Signature *

Clear Signature

Date *

Comment

We proudly cater to the Indiana communities of
Mt. Vernon, Boonville, Newburgh, Princeton, and
Ft. Branch, as well as Henderson, Kentucky.

At Chateau Dog and Cat Hospital, we strive to offer our furry patients and their human families a safe, comfortable, soothing environment, and we look forward to continuing to provide you with the highest standard of veterinary care.

New Pet Form

New Pet Form

Owner Information

Pet Information

We proudly cater to the Indiana communities of
Mt. Vernon, Boonville, Newburgh, Princeton, and
Ft. Branch, as well as Henderson, Kentucky.

Request an Appointment Online!

Have a question?

New Pet Form

New Pet Form

Owner Information

Pet Information

We proudly cater to the Indiana communities ofMt. Vernon, Boonville, Newburgh, Princeton, andFt. Branch, as well as Henderson, Kentucky.

We proudly cater to the Indiana communities of
Mt. Vernon, Boonville, Newburgh, Princeton, and
Ft. Branch, as well as Henderson, Kentucky.