Rustburg Veterinary Clinic offers our patient forms online so you can complete them in the convenience of your home or office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download in order to view these forms.
• If this is your first visit to Rustburg Veterinary Clinic, please download the Client Registration and Pet Health History forms, print them out and fill in the required information.
• Fax your printed and completed forms to us at 888-821-2549 or bring them with you to your appointment.
• We respect your privacy: all information provided is for in-office use only, will not be sold, and will not be shared except by your request.

Client Registration Form

This lets us record our pet owners into our management software so that we can effectively and efficiently provide the service you deserve!  The Client Registration Form is a one-time form and only necessary on your first visit to Rustburg Veterinary Clinic.  You may either print the form using the link below and bring it in or fax it to us, or fill out the form at the time of your appointment.

Pet Health History form

This lets us know the history and current state of your pet's health.  Let us know your questions, concerns, and goals regarding the care of your pet!  For multiple pets, please print and fill out a separate form for each.  This form is only necessary during each pet's first visit.

VA Veterinary Disclosure Form

Receipt and signature of this form is required by the commonwealth in the event that your pet remains at the vet clinic during non-staffed hours.  If you have not previously filled out this form, and your pet is undergoing a surgical procedure that may require an overnight stay, please either print the form using the link below and bring it in or fax it to us, or fill out the form at the time of your appointment.

Download & Print VA Veterinary Disclosure Form