Start your journey in seconds

Please take a few moments to fill out our New Patient Form using one of the options below if your pet is a new patient at Gluckstadt Animal Hospital.

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Multiple ways to fill out the new patient form

Complete Form

Complete and submit the online form below.

Complete Form

Print & Complete

Please download and complete the patient form before your visit to help us serve you more efficiently.

Complete on Arrival

If you prefer, fill out the form when you get to our hospital.

View Open Hours

Owner Information

Owner First Name *

Owner Last Name *

Phone Number *

Email *

Address *

City *

Zip Code *

Apt/Unit

County *

Spouse/Partner

Secondary Number

How did you learn about our practice? *

Frequently Asked Questions About Patient Forms

What our clients say

Dawson G

Dr. Johnson may be the best vet in the state of Mississippi. He has taken care of our dog for years and is honest, caring, and everything a vet should be. I have recommended him to so many people over the years, and not one of them has had a negative thing to say, in fact, someone even drives from Tupelo to see him!

Book an Appointment at Welcome to Gluckstadt Hospital

New pets are always welcome at Welcome to Gluckstadt Hospital. Our friendly veterinary staff looks forward to providing our neighbors in Citrus Heights and surrounding communities with the veterinary care they need.

Book Online
Rottweiler Dog