Thank you for giving us the opportunity to care for your pet(s). So that we may become acquainted, please complete the following form. When done, click submit to send the form information to us

Your Information

Please fax 203-975-1653 or email (info@mybhph.com) all previous medical history, vaccination records and any medications your pet is taking. In order to provide the best possible care for your pet, records MUST be received 48 hours prior to your appointment for our doctors review. If not received, your appointment may be rescheduled.

Pet #1 Information

If yes please provide ID#

Pet #2 Information

If yes, please provide ID#

Pet #3 Information

If yes, please provide ID#
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