East San Rafael Veterinary Clinic offers patient form(s) online so you can complete them in the convenience of your own home or office.

1. If you do not already have AdobeReader® installed on your computer, Click Here to download.
2. Download the necessary form(s), print it out and fill in the required information.
3. Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Registration Form – Required

Please complete this form with your and your pet’s basic information so that we may effectively and efficiently provide the service you deserve!

• Click and Submit Online
• Click to Download and Print Out

Patient Exam Questionnaire – Required

In an effort to keep our clients and staff as healthy as possible, we are limiting clients’ ability to enter the facility directly. Because of this, we request that you fill out this exam summary electronically prior to your appointment.

• Click and Submit Online