New Client/Patient Information

Owner's Name *

First

Last

Email *

Primary Phone *

Secondary Phone

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you 18 years of age or older? *

Yes
No

Spouse/Co-Owner's Name

First

Last

Spouse/Co-Owner's Phone

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

Alternative/Emergency Contact *

First

Last

Alternative/Emergency Contact's Phone *

Pet Information

Pet's Name *

Species *

Dog
Cat
Other

Age/Date of Birth *

Breed *

Color/Markings *

Sex *

Male
Male (neutered)
Female
Female (spayed)

Any allergies?

Please list any pre-existing medical conditions

Where can pet records be obtained from? *

Phone *

Do you already have a scheduled appointment? Please specify Date and Time.

Date

Time

Do you have an additional pet to add? *

Yes
No

Agreements

To help prevent the spread of infectious diseases, hospitalized or boarded/daycare animals must be current on all vaccinations. DUE TO STATE LAW AND INSURANCE REQUIREMENTS ALL ANIMALS MUST BE CURRENT ON RABIES VACCINATION. Vaccinations can be updated at the time of appointment if the animal is not current.

I understand that payment is due when services are rendered, and that I am fully responsible for that payment at the time of the visit. *

I understand

Do you give permission for any pictures taken during your pet’s stay to be used on our social media/website? *

Yes
No

We accept all major credit cards, cash, and CareCredit for payments. If using CareCredit, the account/cardholder must be present with a photo ID for all transactions. We do not accept checks.

Signature *

Clear Signature

Name

Your preferred Chalmette, LA veterinarian.

Name: Paris Road Animal Hospital
Address: 2510 Paris Road, Chalmette, KA, 70043, United States
Telephone: 504-277-1277
Price range: $

Our veterinary hospital is owned and run by Dr. Christopher Baudy, Dr. Alexandrea Baudy and Dr. Nicolas Rose who are all licensed, experienced veterinarians.

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Contact

Phone: 504-277-1277
Email: parisroadah@gmail.com

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Location

2510 Paris Road
Chalmette, Louisiana 70043
Click here for directions.

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HOURS

Mon, Tue, Thur & Fri: 7:30am – 5:00pm
Wed: 8:00am – 2:00pm
Sat: 8:00am – 12:00pm
Sun: Closed

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Pet Information

Additional Pet Information

Agreements

Your preferred Chalmette, LA veterinarian.

Contact

Location

HOURS

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