(859) 987-6721 customerservice@centralkyvet.com

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New Client Form

Embark on a journey of pet wellness by filling out our new client form. Central Kentucky Veterinary Services is your trusted partner.

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Online forms

New Client Form

Embark on a journey of pet wellness by filling out our New Client Form. Central Kentucky Veterinary Services is your trusted partner.

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New Client Form

Please complete this form to help us understand you and your pet before your visit. We look forward to meeting you both soon!

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

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a second pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a third pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a fourth pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Do you have a fifth pet? *

Yes
No

Pet's Name *

Species (dog, cat, etc.) *

Breed (copy) *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

Does your pet have a microchip identification? *

Yes
No

What is the microchip number?

Payment is due in full at the time that services are performed. If being admitted into the hospital, we cannot begin the care of your pet until you have confirmed your desire to do so by 1) signing the client consent & estimate form, and 2) leaving an initial deposit of 50% of the upper end of the estimate. This is the only way that we have of knowing for certain that you want us to proceed with the care of your pet. We accept cash, American Express, Visa, MasterCard, Discover, and CareCredit payments. We neither extend credit, nor bill for services. All open invoices are sent to collections after 45 days unless prior arrangements are made. *

I have read and accept the financial policy.

Name

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PetDesk App

Ready to Visit?

Make An Appointment

We proudly serve the pets of Bourbon and surrounding counties. We look forward to seeing you and your pet soon. Request an appointment for your pet using our online system on PetDesk, and keep up with your pet’s health by downloading our app!

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Questions?

We’re Here to Help

Get in touch! Please complete the form, and a member of our veterinary team will reach out shortly.

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Location

400 Bethlehem Rd.
Paris, KY 40361

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Contact Information

Email: customerservice@centralkyvet.com

Phone: (859) 987-6721

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Hours

Monday-Thursday: 7:00am – 6:00pm

Friday: 8:00am – 5:00pm

Saturday: 8:00am – 12:00pm

Sunday: Closed

We are closed for lunch from Noon until 1:00pm Monday through Friday.

Doctors hours are by appointment between 8:00am and 4:40pm.

Name *

First

Last

Email *

Phone

How can we help you? *

Phone

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