Skip to main content
  • Client Information

  • Patient Information

  • Date Format: MM slash DD slash YYYY
  • Please provide the most recent dates for the following (if you know)
  • 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.