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Hours 612 North Belt Line Road
Grand Prairie, TX 75050

About
Services
Boarding & Daycare
Pet Corner
Contact

Request an Appointment

Request an Appointment
Call: (972) 262-2684
Hours
About
Services
Boarding & Daycare
Pet Corner
Contact
Download Our App
Careers

New Patient Form

Patient Information:

Pet's Name

Pet Species:

Feline

Canine

Pet Breed(s):

Color:

Age / DOB

Is your pet

Male

Female

Male Neutered

Female Spayed

Microchip #:

General Information

If needed, where can we obtain previous medical records for your pet? Previous Veterinarian and Phone Number

Is your pet currently on a monthly heartworm preventative?

Yes

No

If yes, which type?

Is your pet currently on monthly flea preventative?

Yes

No

If yes, which type?

Is your pet currently on any medications?

Yes

No

If yes, please list:

Is your pet allergic to any medications?

Yes

No

If yes, please list:

Do you have any other pets in the household?

Yes

No

If yes, please list:

Texas Veterinary Licensing Act prohibits the disclosure of your name, address, and pet health records to other clinics, grooming, and boarding facilities without your authorization.

Would you allow us to release vaccine records to your boarding kennel and/or groomer?

Yes

No

Would you allow us to release your contact information to someone who has found your pet?

Yes

No

Would you allow Animal Clinic of Grand Prairie permission to use your pet(s) names and pictures for display, public relations and marketing?

Yes

No

Full payment is required at the time of service. I understand that the staff will provide me with a treatment plan for estimated charges upon my request. By acknowledging below, I understand that I am financially responsible for all treatment services provided and medication prescribed.

I understand that I am financially responsible for all treatment services provided and medication prescribed.

Animal Clinic of Grand Prairie

612 North Belt Line Road Grand Prairie, TX 75050 email: acgpvets@gmail.com phone: (972) 262-2684 fax: (972) 264-5190

Serving the Grand Prairie, TX area, including (but not limited to): Irving, Dallas, Arlington, and Euless.

Office Hours

Monday: 8:00 AM - 6:00 PM*

Tuesday: 8:00 AM - 6:00 PM*

Wednesday: 8:00 AM - 6:00 PM*

Thursday: 8:00 AM - 6:00 PM*

Friday: 8:00 AM - 6:00 PM*

Saturday: 8:00 AM - 1:00 PM

Sunday: Closed

Book your pet's next appointment >

View our holiday hours and closings >

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