Appointment Request (GLAH)

If this is an emergency and your pet is in pain, injured or you need an appointment today please call our office.

Your Name:

Your Pet's Name:

Phone Number:

Email Address:

I Prefer to be Contacted By:
 Phone Email

Type of Appointment:

 New Patient Regular Appointment Follow-up Appointment

Preferred Doctor:

Your Companion Animal:
 Canine Feline

Best Days of the Week:

 Monday Tuesday Wednesday Thursday Friday Saturday Sunday (Green Lake location only)

Best Time of Day:

 Early Morning 8am - 10am Mid Morning 10am - 12pm Early Afternoon 12pm - 3pm Late Afternoon 3pm - 5pm

Promo Code:

Concerns/Reason for visit: