(309) 691-5414
brownanimalhospital46@yahoo.com

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Book Appointment

Home
About Us
- Our Team
- Reviews
- Photo Gallery
- Careers
- Contact
Services
Resources
Specials
Book Appointment

New Client Form

To save time during your first appointment, please complete the New Client Form before you visit.

New Client Form

Please fill out this form as completely and accurately as possible. That way, we can get to know you and your pet before you arrive!

Name *

First

Last

Email *

Primary Phone Number *

Secondary Phone Number

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 Number of Authorized Person

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 for 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 for 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 for 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 for identification? *

Yes
No

What is the microchip number?

Do you have a fifth 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 for identification? *

Yes
No

What is the microchip number?

Payment is due in full at the time that services are performed. If admitted into the hospital, we cannot begin caring for 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 our only way of knowing for certain that you want us to proceed with the care of your pet. We accept major credit cards, cash, and CareCredit payments. *

I have read and accept the financial policy.

Message

Ready For a Visit?

Serving the beloved pets of Peoria and its neighboring areas is our pride and joy. Please schedule an appointment today by clicking the button below.

We look forward to extending a warm welcome to you and your furry companion!

Book Appointment

A dog and a cat peacefully sitting side by side

Have a Question?

Please get in touch with us today by completing our online form! We will respond to you shortly.



Contact

P: (309) 691-5414
E: brownanimalhospital46@yahoo.com



Location

1715 W Chanute Road
Peoria, Illinois 61615



Hours

Mon–Fri: 8 AM – 5 PM
Sat: 8 AM – 12 PM
Sun: Closed

Name *

First

Last

Email *

Phone Number

How can we help you? *

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