Dauphin, MB
uptownpc@mymts.net
Call: (204) 638-8887
Monday-Friday: 9 AM - 5 PM Saturday-Sunday: Closed

uptownpc@mymts.net
Call: (204) 638-8887

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New Client Form

If you would like to make an appointment, you can assist us in expediting your check-in by submitting this form. Thank you for your cooperation in letting us assist you.

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New Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Phone Type

Phone Number *

Email Address *

Pet's Name *

Birthdate (month, day, year)

Type of Pet *

Breed

Sex *

Male
Female

Neutered/ Spayed

Neutered
Spayed

Are your pets vaccinations up to date? *

What type were they given and when? *

Do you have pets medical records?

Medical records at another veterinary Practice?

Name of Former Veterinary Practice *

May we request a transfer of records?

Reasons or conditions that prompted your visit?

Special requests or conditions?

Please list any additional pets here

Name

We’re excited to meet you

We proudly serve the pets of Dauphin, Gilbert Plains, Grandview, Ethelbert, Ochre River, and beyond. We look forward to seeing you and your pet! Request an appointment by clicking on the button below or giving us a call at (204) 638-8887.

Book Appointment



Address

519 Main Street North
Dauphin, MB R7N 1E1, CA

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Contact Information

Call: (204) 638-8887
Fax: (204) 638-4667
Email: uptownpc@mymts.net

Have a Question?

Get in touch! We look forward to hearing from you.

Name *

First

Last

Email *

Phone

How can we help you? *