New Client Form

Turtle Mountain Veterinary Service

1040 Highway 5 NE
Bottineau, ND 58318

(701)228-3075

turtlemountainvet.com

We are accepting new clients on a limited basis. Please fill out the form below and a staff member will contact you within a few business days. Completion of this form is not a guarantee of service. If accepted as a new client, a non-refundable deposit will be required to schedule the first appointment which can be taken as a credit card payment over the phone or cash/check payment in person.

New Client Form Form

Name (required)

First Name (required)	Last Name (required)

Address (required)
Street Address (required)

City (required) ,	State / Province (required)	Zip / Postal Code (required)

Phone (required)
Phone Type	Phone Number (required)

E-Mail Address :

Type and number of pets/livestock? (required)

Services needed (routine/wellness vs sick/problem visit)? (required)

Are you currently established with a veterinarian? (required)
Yes
No

Name of current/last veterinarian and location?

Are you willing to pay a non-refundable deposit to schedule your first visit? (required)
Yes
No

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