Online Forms

New Client Form

Thank you for choosing Los Lunas Animal Clinic. Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Who else is authorized to make decisions about your pet's healthcare? *

First

Last

Phone

How did you find out about our hospital? If you were referred by someone, who should we thank? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Do you have another pet to add? *

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Do you have another pet to add? *

Pet's Name *

Species (dog, cat, etc) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Do you have another pet to add? *

Pet's Name *

Species (dog, cat etc) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Payment is due in full at the time that services are performed. We accept Cash, Visa, MasterCard, Discover, Scratchpay, and CareCredit payments. We neither extend credit, nor bill for services. *

I have read and accept the financial policy.

Ready to visit us?

Los Lunas Animal Clinic proudly serves the pets of Los Lunas, Valencia County, and Bernalillo County. We pledge and promise that we will always do our very best to serve you and provide your pets with the quality care that they deserve. Book an appointment today!

Book Appointment

Have a question?

Get in touch! Complete our form, and a member of our team will be in touch with you shortly. We are available 24/7/365 for equine emergencies and C-Sections.

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Address

575 NM-314, Los Lunas, NM 87031

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contact

Phone: (505) 865-4604
Fax: (505) 865-8436
Email: [email protected]



Hours

Mon-Fri: 8:00 AM – 5:30 PM
Sat: 8:00 AM – 12:00 PM
Sunday: Closed

Name *

First

Last

Email *

Phone

How can we help you? *

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