Online Forms

New Client Information

Our Veterinarians and staff are dedicated to deliver the highest quality customer and pet service. Lefferts Veterinary Clinic offers our New Patient form online so you can complete it at your convenience. Please call (718) 849-3000 with any questions or to make an appointment. For your convenience, you can download the form as PDF file or fill out the New Client form on this page.

New Client Information

Best Number to Call
How did you hear about our clinic?
REQUEST AN APPOINTMENT
ALL FEES DUE AT TIME OF SERVICES RENDERED
Choice of Payment
Pet information
Name / Location of hospital where your pet was vaccinated last:
Other then spay/neuter, what surgeries has your pet undergone?
List any current medications your pet takes, including heartworm preventative
Has your pet had any allergic reactions to medications, injections or vaccinations in the past?