Appointments at Baldwin Animal Hospital
Telemedicine Appointments at Baldwin Animal Hospital

Ph: (516) 223-1555

Fax: (516) 223-6626

1864 Grand Avenue, Baldwin NY 11510

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New Account Information

Thank you for giving Baldwin Animal Hospital the opportunity to care for your pet. So that we may become better acquainted, please provide the following:


CLIENT INFORMATION

Marked fields are required (*)

Owner(s) Name: (*)
Address Street: (*)
Apt, Suite:
City: (*)
State: (*)
ZIP: (*)
Email(*)
Home Phone: (please use dashes 000-000-0000)
Cell Phone: (please use dashes 000-000-0000)
Work Phone: (please use dashes 000-000-0000)
Spouse/Companion:
Spouse/Companion - Home Phone: (please use dashes 000-000-0000)
Spouse/Companion - Cell Phone: (please use dashes 000-000-0000)
Spouse/Companion - Work Phone: (please use dashes 000-000-0000)

How did you become aware of our hospital? Yellow Book (local)/Yellow Pages/Internet/Hospital Sign/Web site.
If personal recommendation, whom may we thank?


PET INFORMATION

Pet's Name: (*)
Birth Date: (*)
Species: (*)
Breed:
Sex:
Male    Female

Spayed/Neutered:
Yes    No

Color: (*)
Date of last vaccination(s):
Last Vet Visit:
Surgeries/Chronic Health Problems:
Please list any other pet family members:
I understand that all fees are due when services are rendered. Forms of payment accepted check any/all that may apply:
Cash
Debit
Visa
Mastercard
Discover
American Express
Care Credit

(In the event arrangements are made to accept a Check and it’s returned for non-payment there is a $ 25.00 fee)

*By providing us with your e-mail address you may open a personal pet portal through our website, allowing you to view your pets’ vaccine history, refill medications and contact us.

May we have permission to publish your pet(s) photo to the internet/our website:
Yes
No

OWNER SIGNATURE | Entering your name here serves as a digital signature: (*)
DATE: (*)
  • Animal Hospital in Baldwin NY

Hospital Hours

Mon
Tues
Wed
Thurs
Fri
Sat

8 AM - 5:30 PM
8 AM - 7 PM
8 AM - 4 PM
8 AM - 7 PM
8 AM - 4 PM
8 AM - 1 PM

Online Reviews

  • Everyone at Baldwin Animal Hospital is FANTABULOUS!!!! They love my dog like he is there dog. And he's grumpy old dog at times, but they are very patient with him. I would recommend Baldwin Animal Hospital to any pet owner. You will be very satisfied with the care your furry friend will receive.
  • I wish this was my doctors office! They are the most friendly and accommodating office. Always smiling and always giving great advice to new us new pet owners. Keep up the great work!
  • I have been going to Baldwin Animal Hospital for years. The care that all of my dogs have received from Dr Saslow, Dr Munro and the entire staff has been loving, personal and exceptional. My dogs have been happy to go to the vet because they always get a loving welcome.
  • I have had nothing but a GREAT experience at Baldwin Animal Hospital. Would recommend it to everyone who loves there fur babies.

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