New Patient Form

Please fill out the New Patient Form below if your pet is a new patient with us at Torrance Companion Animal Hospital.

Book An Appointment
Option 1

Complete Online

Complete and then submit the form below. 

Option 2

Print & Complete

Complete the form at home and bring it in with you to our hospital.

Download Form

Option 3

Complete on Arrival

You can also fill out the form once you have arrived at our hospital. 

New Patient Form

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Torrance Companion Animal Hospital to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Torrance Companion Animal Hospital to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Torrance Companion Animal Hospital.

New patients are always welcome.

We look forward to meeting your precious pet at Torrance Companion Animal Hospital.

Contact Us

(310) 781-1434