Name: Lincoln Square Animal Hospital
Address: 4501 North Lincoln Avenue at Sunnyside in Lincoln Square, Chicago, IL, 60625, US
Telephone: 773-271-1901
Price range: $$

Client Information
Your First and Last Name (required)*
What is your pronoun preference?
Secondary Owner's First and Last name (if applicable)
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Phone Number (required)*
Secondary Phone Number
Your Email (required)*
Additional Email
Preferred contact method*
- Email
- Text
- Phone Call
How did you hear about us
- Walk by/Live in the neighborhood
- Google
- Yelp
- Client
- Other
If client or other please specify here
Does the owner or anyone in the household have allergies to Peanut Butter? (Required)*
- Yes
- No
Patient Information
Pet's Name (required)*
Species (required)*
Breed (required)*
Color (required)*
Date of birth/approximate age (required)*
Date Format: MM slash DD slash YYYY
Sex (required)
- Male
- Female
Neutered/Spayed: (required)
Name of Previous Animal Hospital
Please provide the most recent dates for the following (if you know)
Canine DHLPP Vaccination
Rabies Vaccination
Canine Bordetella Vaccination
Canine Lyme Vaccination
Heartworm Test
Result
Does your pet have any allergies to medication or other substances? (required)*
Is your pet currently on any medications? (required)*
Has your pet been treated for any major medical problems? (required)*
Does your pet have any behavior problems? (required)*
Is your pet's food dry or soft?
- Dry
- Soft
Which brand?
How often do you feed your pet?
How much do you feed your pet?
I understand that the hospital staff will provide an estimate of current and anticipated charges any time I request one. I understand I am financially responsible for all services at the time of service. Our company reserves the right to decline service to clients whose behavior is deemed inappropriate or disruptive to our operations.*
- I Agree
Optional Photo/Video Authorization
- I Agree
We know our patients are the cutest in town and we love to show them off! Your signature below authorizes Lincoln Square Animal Hospital's use of your pets’ photos or videos on promotional material and/or social media. You waive your right to compensation or privacy for images used.

Contact Us

4501 North Lincoln Avenue
at Sunnyside in Lincoln Square
Chicago, IL 60625

Call Us: 773-271-1901
info@lincolnsquareanimalhospital.com

Appointments

Our goal is to provide a caring & flexible environment for our pets & owners!

We offer a variety of treatment options for your pet. And, we won’t pressure you into scripted protocols. We believe a trip to the vet should be a pleasant adventure for you and your pet.

Hours

Mon, Tues, Thurs, Friday: 9:00am – 7:00pm – Wed, Sat: 9:00am – 5:00pm – Sun: Closed

Client Information

Patient Information

Contact Us

Our goal is to provide a caring & flexible environment for our pets & owners!

Hours