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* Hospital Appointment Request Form *

Please note: This form is intended for scheduling of routine visits and non urgent care only!

If your pet is seriously ill, you should call 584-1223 immediately and schedule an appointment.

Online scheduling is available only for established clients and patients of VVH. If you are a new client or have a new pet, please call our office to register your pet prior to using this form.

All online appointment requests must be made at least 72 hours ahead of time. No Appointment will be confirmed until you are contacted by our office.

 

CLIENT INFORMATION

Name as listed
in our records:

First

Last
 
Email Address:      
Contact Info: 
Day Phone

Evening Phone

Cell Phone
PET INFORMATION
Name(s):
Pet 1

Pet 2

Pet 3

SERVICE REQUESTED

Pet 1: Pet 2: Pet 3:

Comments/ Brief description of any problems:

APPOINTMENT DAY, TIME, AND DOCTOR PREFERENCE:

Please check our Doctor Schedules prior to selecting your day and time preferences.

Day

Time

Doctor

WE CHECK OUR REQUESTS MON-SAT AM AND WILL CONTACT YOU REGARDING YOUR APPOINTMENT WITHIN 24 HOURS. IF YOU DO NOT HEAR FROM US BY PHONE OR EMAIL WITHIN 2 DAYS PLEASE CALL OUR OFFICE!

 

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