Dental Consultation Request Form

Dental Consultation Request Form

Please fill out the form below and a team member will be in contact to schedule an appointment with Dr. Elizabeth McMorran, Dr. Jan Bellows, or Dr. AJ Basta.
Your Name

First NameLast Name
Your Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Your E-Mail Address
example@example.com
Please provide us with information about your pet and their dental situation. Include things like your pet's name, age, breed, and information about the dental problems they're experiencing.
Are you requesting to see a specific doctor?
member of our team will be in touch the next business day to gather more information abour your pet.

Please have the following information available when we contact you:
- Names of ALL animal clinics or hospitals your pet has been to in the last 3 years. This includes ERs, vaccine clinics, cardiologists, internists, neurologists, any surgeons, opthamologists, oncologists, etc. If you'd like to expedite the process and send us any records or pictures you have, you can send those to hometownanimalhospital@nva.com.
- Record of your pet's last Rabies vaccine (such as a signed vaccine certificate) or information on where we can contact for that information.

We will call to request all records on your pet's behalf and use these records to create a picture of the overall health of your pet, their anesthetic history, previous dental procedures, gauge any anesthetic risk and ultimately, help determine scheduling for your consultation.

At the consultation, you can expect:
- A physical exam of your pet by the doctor, including a visual oral assessment.
- A review of your pet's medical history using the records which were provided to us.
- Discussion of any preoperative testing required prior to surgery.
- Surgical recommendations and estimates for those treatment plans
- Scheduling of your surgery based on the recommendation of the doctor.
If you'd like to read more about Drs. McMorran, Bellows, or Basta, please visit our website.

We look forward to speaking with you!
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