Owner's Name *

First

Last

Date *

Preferred Phone *

Phone Type *

Work
Cell
Home

Alternative Phone

Phone Type

Work
Cell
Home

Employer

Job Title

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Would you like to subscribe to future practice newsletters? *

Yes
No

What is your preferred form of contact to discuss estimates, diagnostic results, or general updates for your cat (s)? *

Phone
Email
Either

What time of the day is best to contact you about your cat(s)? *

How many cats do you have? *

Do you have any other pets? *

Yes
No

If yes, please specify *

How did you first hear of our hospital? *

If other, please specify *

May we post pictures of your cat on Facebook or Instagram? *

Yes
No

Alternate Contact Information

Alternate Contact Person *

First

Last

Relationship *

Alternate Contact Phone *

Alternate Contact Email *

May the alternate contact person make decisions regarding your cat on your behalf? *

Yes
No

Authorization

By signing below, you are verifying that this information is correct and I take full responsibility for the cat(s) I have presented today. I understand that I am to pay in full when services are rendered. *

Clear Signature

Signature

Date *

New Client Registration

Alternate Contact Information

Authorization

We are pleased to provide compassionate care for the cats of Acadiana!

Why choose a cat-only veterinary clinic? Cats are immediately insecure when they are taken out of their home. Our comfortable care center is tailored specifically to the needs of your cat. We look forward to seeing you soon!

Contact Info

Location

Hours

Have a question?

Where Cats Come First!

We can't wait to meet you. We're located at 119 1/2 Arnould Blvd, Lafayette, LA 70506.

Book an appointment online!

Cat Clinic of Lafayette is proud to accept Scratchpay.