1600 Hanes Mall Blvd, Winston-Salem, NC 27103 US

New Patient Form

Is your pet a new patient at Carolina Veterinary Specialists in Winston-Salem? Please complete our New Patient Form using one of the following options.

OPTION 1
Complete Online

Fill in and send the form below.

OPTION 2
Print & Complete

Bring the completed form to your appointment with you.

Download Form

OPTION 3
Complete on Arrival

If you'd like, you can complete the form when you arrive at our hospital.

New Patient Form

Please provide us with the following information. 

Owner Information

Patient Information

Payment & Insurance

PAYMENT IN FULL IS EXPECTED AT THE TIME SERVICES ARE RENDERED. Prior to the treatment of your pet we will provide you with an itemized estimate. It is the policy of Carolina Veterinary Specialists to require a deposit on all hospitalized patients and those outpatients having extensive diagnostic or treatment procedures. Please ask our client care team if you have any questions.

Referral Information

Caring for Winston-Salem Pets

At Carolina Veterinary Specialists, we accept new clients to our specialty services by referral only. Our 24/7 emergency service welcomes all clients.

Contact Us