{"id":1949,"date":"2026-06-05T11:20:31","date_gmt":"2026-06-05T11:20:31","guid":{"rendered":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/?page_id=1949"},"modified":"2026-06-05T11:49:11","modified_gmt":"2026-06-05T11:49:11","slug":"new-client-registration-form","status":"publish","type":"page","link":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/new-client-registration-form\/","title":{"rendered":"New Client Registration Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1949\" class=\"elementor elementor-1949\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-30ddb3b e-flex e-con-boxed e-con e-parent\" data-id=\"30ddb3b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fb5932d elementor-widget elementor-widget-shortcode\" data-id=\"fb5932d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1951-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1951\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/guardiananimalhospital.ca\/wp-json\/wp\/v2\/pages\/1949#wpcf7-f1951-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1951\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1951-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<style>\n\/* Guardian Animal Hospital - New Client Registration Form *\/\n\n.gah-new-client-form {\n width: 100%;\n max-width: 100%;\n margin: 0 auto;\n padding: 55px 7%;\n background: #ffffff;\n font-family: \"Open Sans\", Arial, sans-serif;\n color: #0b2f5b;\n box-sizing: border-box;\n}\n\n.gah-new-client-form * {\n box-sizing: border-box;\n}\n\n.gah-form-inner {\n width: 100%;\n max-width: 1180px;\n margin: 0 auto;\n}\n\n.gah-form-title {\n margin-bottom: 34px;\n}\n\n.gah-form-title h2 {\n font-size: 38px;\n line-height: 1.2;\n margin: 0 0 12px;\n color: #194b92;\n font-weight: 700;\n}\n\n.gah-form-title p {\n font-size: 15px;\n line-height: 1.7;\n color: #4d5b6b;\n margin: 0 0 12px;\n}\n\n.gah-note {\n width: 100%;\n font-size: 14px;\n line-height: 1.7;\n color: #334155;\n background: #f8fafc;\n border-left: 4px solid #f4c542;\n padding: 15px 18px;\n border-radius: 12px;\n margin-top: 16px;\n}\n\n.gah-form-section {\n width: 100%;\n margin-top: 38px;\n padding-top: 30px;\n border-top: 1px solid #e5eaf0;\n}\n\n.gah-form-section h3 {\n font-size: 24px;\n line-height: 1.3;\n margin: 0 0 22px;\n color: #194b92;\n font-weight: 700;\n}\n\n.gah-form-row {\n width: 100%;\n display: grid;\n grid-template-columns: repeat(2, minmax(0, 1fr));\n gap: 18px;\n}\n\n.gah-form-group {\n width: 100%;\n margin-bottom: 16px;\n}\n\n\/* Important: Remove CF7 extra line break gap *\/\n.gah-new-client-form br {\n display: none !important;\n}\n\n.gah-new-client-form p {\n margin: 0 !important;\n padding: 0 !important;\n}\n\n.gah-form-group label,\n.gah-radio-group > label {\n display: block;\n font-size: 14px;\n line-height: 1.2;\n font-weight: 700;\n color: #0b2f5b;\n margin: 0 0 10px 0 !important;\n padding: 0 !important;\n}\n\n\/* CF7 Wrap Fix *\/\n.gah-new-client-form .wpcf7-form-control-wrap {\n display: block;\n width: 100%;\n margin: 0 !important;\n padding: 0 !important;\n}\n\n\/* Same Design For All Fields *\/\n.gah-new-client-form input[type=\"text\"],\n.gah-new-client-form input[type=\"email\"],\n.gah-new-client-form input[type=\"tel\"],\n.gah-new-client-form input[type=\"url\"],\n.gah-new-client-form input[type=\"number\"],\n.gah-new-client-form input[type=\"date\"],\n.gah-new-client-form select,\n.gah-new-client-form textarea {\n width: 100% !important;\n max-width: 100% !important;\n border: 1px solid #dbe3ec !important;\n background: #f3f5f7 !important;\n border-radius: 14px !important;\n padding: 14px 18px !important;\n font-size: 14px !important;\n line-height: 1.4 !important;\n color: #0b2f5b !important;\n font-family: \"Open Sans\", Arial, sans-serif !important;\n outline: none !important;\n box-shadow: none !important;\n transition: all 0.25s ease !important;\n margin: 0 !important;\n}\n\n\/* Input \/ Select Height *\/\n.gah-new-client-form input[type=\"text\"],\n.gah-new-client-form input[type=\"email\"],\n.gah-new-client-form input[type=\"tel\"],\n.gah-new-client-form input[type=\"url\"],\n.gah-new-client-form input[type=\"number\"],\n.gah-new-client-form input[type=\"date\"],\n.gah-new-client-form select {\n height: 52px !important;\n min-height: 52px !important;\n}\n\n\/* Textarea Same UI *\/\n.gah-new-client-form textarea {\n height: 120px !important;\n min-height: 120px !important;\n resize: vertical;\n display: block;\n}\n\n\/* Placeholder Same *\/\n.gah-new-client-form input::placeholder,\n.gah-new-client-form textarea::placeholder {\n color: #7b8794 !important;\n opacity: 1 !important;\n font-size: 14px !important;\n}\n\n\/* Focus Same *\/\n.gah-new-client-form input:focus,\n.gah-new-client-form select:focus,\n.gah-new-client-form textarea:focus {\n border-color: #194b92 !important;\n background: #ffffff !important;\n box-shadow: 0 0 0 4px rgba(25, 75, 146, 0.10) !important;\n}\n\n\/* Radio Fields *\/\n.gah-radio-group {\n width: 100%;\n margin-bottom: 18px;\n}\n\n.gah-radio-group .wpcf7-radio {\n display: grid;\n gap: 7px;\n}\n\n.gah-radio-group .wpcf7-list-item {\n display: block;\n margin: 0 !important;\n}\n\n.gah-radio-group .wpcf7-list-item label {\n display: inline-flex;\n align-items: center;\n gap: 8px;\n font-size: 14px;\n line-height: 1.4;\n color: #233d5e;\n font-weight: 500;\n cursor: pointer;\n margin: 0 !important;\n}\n\n.gah-radio-group input[type=\"radio\"] {\n width: 15px;\n height: 15px;\n margin: 0;\n accent-color: #194b92;\n}\n\n\/* Submit Button *\/\n.gah-submit-wrap {\n width: 100%;\n margin-top: 30px;\n}\n\n.gah-new-client-form input[type=\"submit\"] {\n display: inline-flex;\n align-items: center;\n justify-content: center;\n min-height: 50px;\n border: none;\n outline: none;\n background: #f4c542;\n color: #0b2f5b;\n border-radius: 100px;\n padding: 15px 34px;\n font-size: 15px;\n line-height: 1;\n font-weight: 700;\n font-family: \"Open Sans\", Arial, sans-serif;\n cursor: pointer;\n transition: none !important;\n}\n\n\/* Button hover removed *\/\n.gah-new-client-form input[type=\"submit\"]:hover,\n.gah-new-client-form input[type=\"submit\"]:focus,\n.gah-new-client-form input[type=\"submit\"]:active {\n background: #f4c542 !important;\n color: #0b2f5b !important;\n box-shadow: none !important;\n transform: none !important;\n}\n\n\/* CF7 Response *\/\n.gah-new-client-form .wpcf7-response-output {\n margin: 25px 0 0 !important;\n padding: 14px 18px !important;\n border-radius: 12px;\n font-size: 14px;\n}\n\n.gah-new-client-form .wpcf7-not-valid-tip {\n margin-top: 6px;\n font-size: 13px;\n}\n\n\/* Mobile Responsive *\/\n@media (max-width: 991px) {\n .gah-new-client-form {\n padding: 45px 5%;\n }\n\n .gah-form-title h2 {\n font-size: 32px;\n }\n}\n\n@media (max-width: 767px) {\n .gah-new-client-form {\n padding: 35px 18px;\n }\n\n .gah-form-title h2 {\n font-size: 28px;\n }\n\n .gah-form-section {\n margin-top: 32px;\n padding-top: 26px;\n }\n\n .gah-form-section h3 {\n font-size: 22px;\n }\n\n .gah-form-row {\n grid-template-columns: 1fr;\n gap: 0;\n }\n\n .gah-form-group {\n margin-bottom: 15px;\n }\n\n .gah-new-client-form input[type=\"text\"],\n .gah-new-client-form input[type=\"email\"],\n .gah-new-client-form input[type=\"tel\"],\n .gah-new-client-form input[type=\"url\"],\n .gah-new-client-form input[type=\"number\"],\n .gah-new-client-form input[type=\"date\"],\n .gah-new-client-form select {\n height: 50px !important;\n min-height: 50px !important;\n border-radius: 12px !important;\n padding: 13px 16px !important;\n }\n\n .gah-new-client-form textarea {\n height: 115px !important;\n min-height: 115px !important;\n border-radius: 12px !important;\n padding: 13px 16px !important;\n }\n}\n<\/style>\n<div class=\"gah-new-client-form\">\n\t<div class=\"gah-form-inner\">\n\t\t<div class=\"gah-form-title\">\n\t\t\t<h2>New Client Registration Form\n\t\t\t<\/h2>\n\t\t\t<p>Thank you for considering our hospital as your pet\u2019s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together.\n\t\t\t<\/p>\n\t\t\t<div class=\"gah-note\">\n\t\t\t\t<p>Please complete this form as fully as possible before your first appointment. Required fields are marked with an asterisk.\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"gah-form-section\">\n\t\t\t<h3>Owner\u2019s Information\n\t\t\t<\/h3>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>First Name *<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"owner-first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First name\" value=\"\" type=\"text\" name=\"owner-first-name\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Last Name *<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"owner-last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Last name\" value=\"\" type=\"text\" name=\"owner-last-name\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>Street Address *<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"street-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Street address\" value=\"\" type=\"text\" name=\"street-address\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>Address Line 2<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address-line-2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Address line 2\" value=\"\" type=\"text\" name=\"address-line-2\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>City<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"City\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>State \/ Province \/ Region<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"state-province\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"State \/ Province \/ Region\" value=\"\" type=\"text\" name=\"state-province\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>ZIP \/ Postal Code<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"postal-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"ZIP \/ Postal Code\" value=\"\" type=\"text\" name=\"postal-code\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Country<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"country\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"country\"><option value=\"Canada\">Canada<\/option><option value=\"Afghanistan\">Afghanistan<\/option><option value=\"Albania\">Albania<\/option><option value=\"Algeria\">Algeria<\/option><option value=\"Andorra\">Andorra<\/option><option value=\"Angola\">Angola<\/option><option value=\"Antigua and Barbuda\">Antigua and Barbuda<\/option><option value=\"Argentina\">Argentina<\/option><option value=\"Armenia\">Armenia<\/option><option value=\"Australia\">Australia<\/option><option value=\"Austria\">Austria<\/option><option value=\"Azerbaijan\">Azerbaijan<\/option><option value=\"Bahamas\">Bahamas<\/option><option value=\"Bahrain\">Bahrain<\/option><option value=\"Bangladesh\">Bangladesh<\/option><option value=\"Barbados\">Barbados<\/option><option value=\"Belarus\">Belarus<\/option><option value=\"Belgium\">Belgium<\/option><option value=\"Belize\">Belize<\/option><option value=\"Benin\">Benin<\/option><option value=\"Bhutan\">Bhutan<\/option><option value=\"Bolivia\">Bolivia<\/option><option value=\"Bosnia and Herzegovina\">Bosnia and Herzegovina<\/option><option value=\"Botswana\">Botswana<\/option><option value=\"Brazil\">Brazil<\/option><option value=\"Brunei\">Brunei<\/option><option value=\"Bulgaria\">Bulgaria<\/option><option value=\"Burkina Faso\">Burkina Faso<\/option><option value=\"Burundi\">Burundi<\/option><option value=\"Cabo Verde\">Cabo Verde<\/option><option value=\"Cambodia\">Cambodia<\/option><option value=\"Cameroon\">Cameroon<\/option><option value=\"Central African Republic\">Central African Republic<\/option><option value=\"Chad\">Chad<\/option><option value=\"Chile\">Chile<\/option><option value=\"China\">China<\/option><option value=\"Colombia\">Colombia<\/option><option value=\"Comoros\">Comoros<\/option><option value=\"Congo\">Congo<\/option><option value=\"Costa Rica\">Costa Rica<\/option><option value=\"Croatia\">Croatia<\/option><option value=\"Cuba\">Cuba<\/option><option value=\"Cyprus\">Cyprus<\/option><option value=\"Czech Republic\">Czech Republic<\/option><option value=\"Denmark\">Denmark<\/option><option value=\"Djibouti\">Djibouti<\/option><option value=\"Dominica\">Dominica<\/option><option value=\"Dominican Republic\">Dominican Republic<\/option><option value=\"Ecuador\">Ecuador<\/option><option value=\"Egypt\">Egypt<\/option><option value=\"El Salvador\">El Salvador<\/option><option value=\"Equatorial Guinea\">Equatorial Guinea<\/option><option value=\"Eritrea\">Eritrea<\/option><option value=\"Estonia\">Estonia<\/option><option value=\"Eswatini\">Eswatini<\/option><option value=\"Ethiopia\">Ethiopia<\/option><option value=\"Fiji\">Fiji<\/option><option value=\"Finland\">Finland<\/option><option value=\"France\">France<\/option><option value=\"Gabon\">Gabon<\/option><option value=\"Gambia\">Gambia<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Germany\">Germany<\/option><option value=\"Ghana\">Ghana<\/option><option value=\"Greece\">Greece<\/option><option value=\"Grenada\">Grenada<\/option><option value=\"Guatemala\">Guatemala<\/option><option value=\"Guinea\">Guinea<\/option><option value=\"Guinea-Bissau\">Guinea-Bissau<\/option><option value=\"Guyana\">Guyana<\/option><option value=\"Haiti\">Haiti<\/option><option value=\"Honduras\">Honduras<\/option><option value=\"Hungary\">Hungary<\/option><option value=\"Iceland\">Iceland<\/option><option value=\"India\">India<\/option><option value=\"Indonesia\">Indonesia<\/option><option value=\"Iran\">Iran<\/option><option value=\"Iraq\">Iraq<\/option><option value=\"Ireland\">Ireland<\/option><option value=\"Israel\">Israel<\/option><option value=\"Italy\">Italy<\/option><option value=\"Jamaica\">Jamaica<\/option><option value=\"Japan\">Japan<\/option><option value=\"Jordan\">Jordan<\/option><option value=\"Kazakhstan\">Kazakhstan<\/option><option value=\"Kenya\">Kenya<\/option><option value=\"Kiribati\">Kiribati<\/option><option value=\"Kuwait\">Kuwait<\/option><option value=\"Kyrgyzstan\">Kyrgyzstan<\/option><option value=\"Laos\">Laos<\/option><option value=\"Latvia\">Latvia<\/option><option value=\"Lebanon\">Lebanon<\/option><option value=\"Lesotho\">Lesotho<\/option><option value=\"Liberia\">Liberia<\/option><option value=\"Libya\">Libya<\/option><option value=\"Liechtenstein\">Liechtenstein<\/option><option value=\"Lithuania\">Lithuania<\/option><option value=\"Luxembourg\">Luxembourg<\/option><option value=\"Madagascar\">Madagascar<\/option><option value=\"Malawi\">Malawi<\/option><option value=\"Malaysia\">Malaysia<\/option><option value=\"Maldives\">Maldives<\/option><option value=\"Mali\">Mali<\/option><option value=\"Malta\">Malta<\/option><option value=\"Marshall Islands\">Marshall Islands<\/option><option value=\"Mauritania\">Mauritania<\/option><option value=\"Mauritius\">Mauritius<\/option><option value=\"Mexico\">Mexico<\/option><option value=\"Micronesia\">Micronesia<\/option><option value=\"Moldova\">Moldova<\/option><option value=\"Monaco\">Monaco<\/option><option value=\"Mongolia\">Mongolia<\/option><option value=\"Montenegro\">Montenegro<\/option><option value=\"Morocco\">Morocco<\/option><option value=\"Mozambique\">Mozambique<\/option><option value=\"Myanmar\">Myanmar<\/option><option value=\"Namibia\">Namibia<\/option><option value=\"Nauru\">Nauru<\/option><option value=\"Nepal\">Nepal<\/option><option value=\"Netherlands\">Netherlands<\/option><option value=\"New Zealand\">New Zealand<\/option><option value=\"Nicaragua\">Nicaragua<\/option><option value=\"Niger\">Niger<\/option><option value=\"Nigeria\">Nigeria<\/option><option value=\"North Korea\">North Korea<\/option><option value=\"North Macedonia\">North Macedonia<\/option><option value=\"Norway\">Norway<\/option><option value=\"Oman\">Oman<\/option><option value=\"Pakistan\">Pakistan<\/option><option value=\"Palau\">Palau<\/option><option value=\"Palestine\">Palestine<\/option><option value=\"Panama\">Panama<\/option><option value=\"Papua New Guinea\">Papua New Guinea<\/option><option value=\"Paraguay\">Paraguay<\/option><option value=\"Peru\">Peru<\/option><option value=\"Philippines\">Philippines<\/option><option value=\"Poland\">Poland<\/option><option value=\"Portugal\">Portugal<\/option><option value=\"Qatar\">Qatar<\/option><option value=\"Romania\">Romania<\/option><option value=\"Russia\">Russia<\/option><option value=\"Rwanda\">Rwanda<\/option><option value=\"Saint Kitts and Nevis\">Saint Kitts and Nevis<\/option><option value=\"Saint Lucia\">Saint Lucia<\/option><option value=\"Saint Vincent and the Grenadines\">Saint Vincent and the Grenadines<\/option><option value=\"Samoa\">Samoa<\/option><option value=\"San Marino\">San Marino<\/option><option value=\"Sao Tome and Principe\">Sao Tome and Principe<\/option><option value=\"Saudi Arabia\">Saudi Arabia<\/option><option value=\"Senegal\">Senegal<\/option><option value=\"Serbia\">Serbia<\/option><option value=\"Seychelles\">Seychelles<\/option><option value=\"Sierra Leone\">Sierra Leone<\/option><option value=\"Singapore\">Singapore<\/option><option value=\"Slovakia\">Slovakia<\/option><option value=\"Slovenia\">Slovenia<\/option><option value=\"Solomon Islands\">Solomon Islands<\/option><option value=\"Somalia\">Somalia<\/option><option value=\"South Africa\">South Africa<\/option><option value=\"South Korea\">South Korea<\/option><option value=\"South Sudan\">South Sudan<\/option><option value=\"Spain\">Spain<\/option><option value=\"Sri Lanka\">Sri Lanka<\/option><option value=\"Sudan\">Sudan<\/option><option value=\"Suriname\">Suriname<\/option><option value=\"Sweden\">Sweden<\/option><option value=\"Switzerland\">Switzerland<\/option><option value=\"Syria\">Syria<\/option><option value=\"Taiwan\">Taiwan<\/option><option value=\"Tajikistan\">Tajikistan<\/option><option value=\"Tanzania\">Tanzania<\/option><option value=\"Thailand\">Thailand<\/option><option value=\"Timor-Leste\">Timor-Leste<\/option><option value=\"Togo\">Togo<\/option><option value=\"Tonga\">Tonga<\/option><option value=\"Trinidad and Tobago\">Trinidad and Tobago<\/option><option value=\"Tunisia\">Tunisia<\/option><option value=\"Turkey\">Turkey<\/option><option value=\"Turkmenistan\">Turkmenistan<\/option><option value=\"Tuvalu\">Tuvalu<\/option><option value=\"Uganda\">Uganda<\/option><option value=\"Ukraine\">Ukraine<\/option><option value=\"United Arab Emirates\">United Arab Emirates<\/option><option value=\"United Kingdom\">United Kingdom<\/option><option value=\"United States\">United States<\/option><option value=\"Uruguay\">Uruguay<\/option><option value=\"Uzbekistan\">Uzbekistan<\/option><option value=\"Vanuatu\">Vanuatu<\/option><option value=\"Vatican City\">Vatican City<\/option><option value=\"Venezuela\">Venezuela<\/option><option value=\"Vietnam\">Vietnam<\/option><option value=\"Yemen\">Yemen<\/option><option value=\"Zambia\">Zambia<\/option><option value=\"Zimbabwe\">Zimbabwe<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Mobile Phone<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"mobile-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"Mobile phone\" value=\"\" type=\"tel\" name=\"mobile-phone\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Email *<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email address\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"gah-form-section\">\n\t\t\t<h3>Co-owner\u2019s Name & Contact\n\t\t\t<\/h3>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>First Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coowner-first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"First name\" value=\"\" type=\"text\" name=\"coowner-first-name\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Last Name<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coowner-last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Last name\" value=\"\" type=\"text\" name=\"coowner-last-name\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>Phone<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"coowner-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"Phone number\" value=\"\" type=\"tel\" name=\"coowner-phone\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"gah-form-section\">\n\t\t\t<h3>Referral Information\n\t\t\t<\/h3>\n\t\t\t<div class=\"gah-radio-group\">\n\t\t\t\t<p><label>How did you find out about our practice?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"referral-source\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"referral-source\" value=\"Clinic Location\" \/><span class=\"wpcf7-list-item-label\">Clinic Location<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"referral-source\" value=\"Personal Referral\" \/><span class=\"wpcf7-list-item-label\">Personal Referral<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"referral-source\" value=\"Internet Search \/ Website\" \/><span class=\"wpcf7-list-item-label\">Internet Search \/ Website<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"referral-source\" value=\"Yellow Pages\" \/><span class=\"wpcf7-list-item-label\">Yellow Pages<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"referral-source\" value=\"Clinic Sign\" \/><span class=\"wpcf7-list-item-label\">Clinic Sign<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"referral-source\" value=\"Newspaper \/ Print Media\" \/><span class=\"wpcf7-list-item-label\">Newspaper \/ Print Media<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"referral-source\" value=\"Other\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>If Other, please specify<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"referral-other\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Please specify\" value=\"\" type=\"text\" name=\"referral-other\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>If Personal Referral, is there someone we can thank for this referral?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"referral-person\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Referral person name\" value=\"\" type=\"text\" name=\"referral-person\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>Please use this area to give us any other relevant information about yourself or your family<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"family-info\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Write your message here\" name=\"family-info\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"gah-form-section\">\n\t\t\t<h3>Pet Information\n\t\t\t<\/h3>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>Pet\u2019s Name *<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pet-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Pet\u2019s name\" value=\"\" type=\"text\" name=\"pet-name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Species *<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"species\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"species\"><option value=\"Dog\">Dog<\/option><option value=\"Cat\">Cat<\/option><option value=\"Bird\">Bird<\/option><option value=\"Rabbit\">Rabbit<\/option><option value=\"Reptile\">Reptile<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Or if other species<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"other-species\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Please specify species\" value=\"\" type=\"text\" name=\"other-species\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Breed<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"breed\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Breed if known\" value=\"\" type=\"text\" name=\"breed\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Color<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pet-color\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Pet color\" value=\"\" type=\"text\" name=\"pet-color\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Date of Birth or Age<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pet-age\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Date of birth or age if known\" value=\"\" type=\"text\" name=\"pet-age\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Sex<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pet-sex\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"pet-sex\"><option value=\"Neutered Male\">Neutered Male<\/option><option value=\"Male\">Male<\/option><option value=\"Spayed Female\">Spayed Female<\/option><option value=\"Female\">Female<\/option><option value=\"Unknown\">Unknown<\/option><\/select><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>Special Identification<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"special-identification\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Tattoo, microchip, etc.\" name=\"special-identification\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-row\">\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Previous Veterinary Practice<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"previous-practice\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Previous veterinary practice if any\" value=\"\" type=\"text\" name=\"previous-practice\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t\t<p><label>Previous Veterinarian<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"previous-veterinarian\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Previous veterinarian if any\" value=\"\" type=\"text\" name=\"previous-veterinarian\" \/><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>Date of Last Vaccines<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-vaccines-date\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Date of last vaccines if known\" value=\"\" type=\"text\" name=\"last-vaccines-date\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>What vaccines were given at this time?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"vaccines-given\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Vaccines given\" value=\"\" type=\"text\" name=\"vaccines-given\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-radio-group\">\n\t\t\t\t<p><label>Is your pet on any medication or supplements?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"medication-status\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"medication-status\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"medication-status\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>If Yes, please list the medication or supplement<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"medication-list\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"List medication or supplement\" name=\"medication-list\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>What food does your pet eat?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pet-food\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Food details\" name=\"pet-food\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-radio-group\">\n\t\t\t\t<p><label>Does your pet have allergies or drug reactions?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"allergies-status\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"allergies-status\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"allergies-status\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>If Yes, please list the allergies and reactions<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"allergies-details\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"List allergies and reactions\" name=\"allergies-details\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-radio-group\">\n\t\t\t\t<p><label>Are there any current or past medical conditions of which we should be aware?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"medical-condition-status\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"medical-condition-status\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"medical-condition-status\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>If Yes, please comment on the conditions, and indicate if they are current or past conditions<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"medical-condition-details\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Medical condition details\" name=\"medical-condition-details\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"gah-form-group\">\n\t\t\t\t<p><label>Please use the following box to give us any other relevant information about your pet<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"pet-extra-info\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Other pet information\" name=\"pet-extra-info\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"gah-submit-wrap\">\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit Registration\" \/>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1949","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/wp-json\/wp\/v2\/pages\/1949","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/wp-json\/wp\/v2\/comments?post=1949"}],"version-history":[{"count":0,"href":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/wp-json\/wp\/v2\/pages\/1949\/revisions"}],"wp:attachment":[{"href":"https:\/\/mycrazykart.com\/guardiananimalhospital.ca\/wp-json\/wp\/v2\/media?parent=1949"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}