Request A Behavioral Medicine Appointment
Requesting an existing client behavioral medicine appointment is easy! Simply fill out the below form and you will be contacted within 24-48 hours. Please note completing this form does not confirm your appointment. If you believe your pet is experiencing a medical emergency, please do not submit this form, but rather call the hospital at 856-234-7626 and follow the prompts to speak with our ER team. Please only complete this form if you are an EXISTING behavioral medicine client. Our Behavioral Medicine Department is currently not accepting new patients at this time. Due to an increasing caseload, our dedicated team is working diligently to improve availability and provide the highest quality care to our existing patients. We understand the importance of timely access to behavioral health services, and we are actively working to expand our capacity to better serve our community. Please be sure to follow us for regular updates on when we will resume accepting new patients. We will keep you informed about our progress and any changes in our availability. We remain committed to delivering exceptional care to our patients, and we appreciate your understanding and patience during this time.
Are you a current patient of Dr. Gilbert Gregory?
*
Yes
No
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pet's name
*
First Name
Last Name
Pets age or date of birth (if known)
*
Sex and alteration status
*
Please Select
Male (not neutered)
Neutered Male
Female (not spayed)
Spayed Female
Unknown
Pet's species
*
Please Select
Canine
Feline
Avian
Rabbit
Guinea Pig
Ferret
Hamster
Rat
Mouse
Chinchilla
Sugar Glider
Reptile
Amphibian
Other
Pet's breed
*
Coat/fur/hair color
*
Appointment type
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Please Select
Follow-up Progress Eval. with Dr. Shana
Happy Visit with Hannah (Tech)
Behavior Modification
Is this a routine progress evaluation or has something happened
6 month routine progress evaluation
Medication Adjustment needed
Change in Behavior
Other
Please explain
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Preferred day of week
*
Sundays
Mondays
Tuesdays (Happy Visits Only)
Wednesdays
Thursdays
Any other information you would like to provide. Please include any days/times that will not work for scheduling to speed up the scheduling process.
If you have a primary veterinarian please list the clinic information including: Name, Address & Phone Number. Include any other vets who have seen your pet for their current medical concern.
Submit
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