2551 W. Whittier Blvd, La Habra, CA 90631

County Line Animal Hospital

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  • Services
    • Bathing
    • Emergencies
    • Euthanasia
    • Flea, Tick, and Heartworm Prevention
    • Fully Stocked Pharmacy
    • Internal Medicine
    • Laser Therapy
    • Microchipping
    • Non-Anesthetic Dentals
    • Nutritional Counseling
    • Pain Management
    • Radiology
    • Surgery
    • Ultrasound
    • Vaccinations
    • Wellness Exams
  • Online Pharmacy
  • Appointments
  • Contact Us

(562) 697-6725

New Client Form

"*" indicates required fields

Owner Information

Name*
Address*

Co-Owner

Name

County Line Animal Hospital requires payment in full at the end of your pet's examination and/or at the time of discharge. When extensive care is needed a 50% deposit may be required prior to starting treatment.

Payment Options: Cash, Debit, Visa®, MasterCard®, American Express® ,Discover Card® and Apple Pay

  • Convenient Monthly Payment Options¹ from the CareCredit® Healthcare CreditCard (Upon Approval)
    • Allow you to begin treatment today and pay over time
    • Available for any treatment amount
**AN ESTIMATE FOR SERVICES WILL BE GIVEN UPON REQUEST ONLY**

I hereby acknowledge that the above information is true and correct. I acknowledge that I am 18 years or older and the legal owner or authorized representative of the legal owner, and that I am authorized to make decisions regarding my pets medical care. I acknowledge that I am legally responsible for all financial care of my pet/s

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Pet Information

Species*
Gender*
Spayed / Neutered*
Does your pet have a microchip?*
Does this pet have pet insurance?*

Medical History

Has your pet ever had a reaction to vaccines?*
Does your pet have any known allergies?*
Is your pet current on vaccines?*
Has your pet had a Fecal Parasite check performed within the last year?*
Has your pet had a Heartworm test performed within the last year?*
Is your dog currently on any medications, supplements or flea/tick medication?*

Lifestyle / Behavior

Has your dog or cat ever bitten a person?*
Is your dog friendly with other dogs?*
May we contact your previous vet for records?*

We love taking pictures of our patients! Please let us know if we can share pictures of your fur baby!

I grant to County Line Animal Hospital , its representatives and employees the right to take photographs of me and/or my pet, and to copyright, use and publish the same in print and/or electronically. I agree that County Line Animal Hospital may use such photographs of me and/or my pet with or without my name and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and Web content.
Drop files here or
Max. file size: 256 MB.
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    Appointments

    We will do our best to accommodate your busy schedule. Request an appointment today!

    Request an Appointment

    Office Hours

    Mon – Fri: 7:30AM – 6:00PM
    Sat: 8:00AM – 5:00PM
    Sun: Closed

    Contact Us

    2551 W. Whittier Blvd
    La Habra, CA 90631

    Phone: (562) 697-6725

    © Copyright 2025 County Line Animal Hospital

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