OUR HOUSE CALL VET               Bergen NJ, Passaic NJ & Rockland NY
       
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Registration Form

    We are currently taking new patients. For new clients, or new pets, please fill out the following registration form: ONE form for EACH PET.  ie. 2 pets, 2 forms.  Please fill out ALL FIELDS of the form, in order for it to process correctly.   If you do not hear back from me within 4 business hours, please call me at 201-803-7705 or e-mail  me at ourhousecallvet@aol.com

    Please include dashes between area code, prefix of phone number.
    Please put dashes between the area code, prefix and suffix of the phone number.
    List the vaccination name AND the date that it was last given.
    This is very important, as it will determine which technician we need to take with us.
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