Veterinarians
Ronny E. Kiehn, DVM
John N. Thomas, DVM
Emergencies
Regular Hours
Call: (580) 477-1623
After-Hours
Call: (580) 477-5274
Office Hours
Monday - Friday
8:00am - 12:00pm
1:00pm - 5:30pm
Saturday
8:00am - 12:00pm
Sunday
Emergency Only
Service Area
Altus, Oklahoma
Jackson County, Oklahoma
Altus Air Force Base, OK
Mangum, Oklahoma
Frederick, Oklahoma
Tipton, Oklahoma
Granite, Oklahoma
Hobart, Oklahoma
Snyder, Oklahoma
Olustee, Oklahoma
Blair, Oklahoma
Martha, Oklahoma
Lone Wolf, Oklahoma
Quartz Mountain State Park
"Friendly & Experienced Pet Health Care."

Patient Update

Update Your Information

Thanks for your interest in Westside Animal Clinic. Whether you are a long-time client or have never visited, it is important that our records of your personal information be correct so that we can provide you and your pets with the best veterinary care available.
If you plan on visiting or your personal information has changed recently, please take a moment to help us update your records. This will not only save you time but also minimize the risk of errors.

Patient Information Sheet

Please complete this short form to update your patient records.
I have never been to Westside Animal Clinic. *
I regularly visit Westside Animal Clinic.
Contact Information:
Name *

Spouse's Name *

Home Phone *

Work Phone *

Cell Phone

Email Address *

Address 1 *

Address 2

City *

State *

Zip Code *
Your Personal Information:
Date of Birth *
,
Social Security # *

Driver's License # *

State *

Expiration *
,
Employer *

Employer Address *
Emergency Contact Information:
Emergency Contact 1 *

Phone *

Emergency Contact 2

Phone

Emergency Contact 3

Phone
First Pet's Information:
Pet Type

Breed

Color

Name

Age

Sex

Current Heartworm Test

Spayed/Neutered

Vaccination Date
,
Second Pet's Information:
Pet Type

Breed

Color

Name

Age

Sex

Current Heartworm Test

Spayed/Neutered

Vaccination Date
,
Third Pet's Information:
Pet Type

Breed

Color

Name

Age

Sex

Current Heartworm Test

Spayed/Neutered

Vaccination Date
,
By checking this box, I agree and consent to the Policies of Westside Animal Clinic. Note: Your information will be kept confidential. *
* indicates required information.
Home | Veterinarian Hours | Hospital Location | Veterinary Services
Emergency Care | Veterinarians | Hospital Staff | Client Services
Appointments | Medical Alert | Hospital Tour | Useful Web Sites
Contact Us | Hospital Policy
Copyright © 2003-2008 Westside Animal Clinic: Your SW Oklahoma Veterinarian & Animal Hospital. All rights reserved.