Western Canada Veterinary Eye Specialists
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Admission Form

Western Canada Veterinary Eye Specialists Inc.
460 East Columbia Street, New Westminster, BC V3L 3X5
Tel: 604 549 4944, Fax: 604 549 4941

* Fields with an asterisk are required.

Owner Information


Phone Number (Please include all contact numbers)

Pet Information

Sex*   Male   Female

Neutered/spayed*   Yes   No

Species*   Canine   Feline   Other

Vaccination_Status   Up to date   Overdue   Unknown

Regular Veterinarian

Do you have Pet Insurance?*   Yes   No

*Please note, we require full payment at the end of each exam. We accept Cash, Debit, Visa, and Mastercard.

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