Large Animal Appointment Request Form
Please fill out the form below to request an appointment with one of our Large Animal Field Service. Species seen include horses, cows, donkeys, sheep, goats, pigs, llamas, alpacas, and camels. A member of our team will get back to you within 48 business hours. If this is an emergency, please call us directly at 833-888-5760 for immediate assistance.
Are you a new or existing client?
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Please Select
New
Existing
Please select your preferred doctor:
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Please Select
Dr. Elizabeth Perry
Dr. Sara Brunsden
Dr. Hannah Neill
Dr. Kristen McCurdy
No Preference
Please be advised that doctor availability is species dependent.
Client Full Name
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First Name
Last Name
Co-Owner
First Name
Last Name
Email Address
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Home Address
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Number and Street Name
Apt/Unit Number (If this does not apply, enter "N/A")
City
State / Province
Postal / Zip Code
Pet information:
If you have a herd of animals, please list this as the pet's name (e.g., "Herd of 10 Goats").
Pet's Name:
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What kind of pet do you have?
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(i.e., Horse, Cow, etc.)
Breed:
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Color:
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Age or Date of Birth:
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Sex:
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Please Select
Female
Male
Is your pet spayed or neutered?
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Please Select
Yes
No
Does your pet live at your home address or at a different location?
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Please Select
My pet lives at my home address.
My pet lives at a different location.
If your pet lives at a different location, what is the name of the facility?
If it is a residential home, please list "residence" above.
If your pet doesn't live at your home address. Please enter the address where your pet is located:
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Number and Street Name
Apt/Unit Number (If this does not apply, enter "N/A")
City
State / Province
Postal / Zip Code
Additional Pets:
Pet's Name (Second Pet):
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What kind of pet do you have? (Second Pet)
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Breed (Second Pet):
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Color (Second Pet):
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Age or Date of Birth (Second Pet):
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Sex (Second Pet):
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Please Select
Female
Male
Is your pet spayed or neutered? (Second Pet)
*
Please Select
Yes
No
Does your pet live at your home address or at a different location? (Second Pet)
*
Please Select
My pet lives at my home address.
My pet lives at a different location.
If your pet lives at a different location, what is the name of the facility (Second Pet)?
If it is a residential home, please list "residence" above.
Pet's Name (Third Pet):
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What kind of pet do you have? (Third Pet)
*
Breed (Third Pet):
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Color (Third Pet):
*
Age or Date of Birth (Third Pet):
*
Sex (Third Pet):
*
Please Select
Female
Male
Is your pet spayed or neutered? (Third Pet)
*
Please Select
Yes
No
Does your pet live at your home address or at a different location? (Third Pet)
*
Please Select
My pet lives at my home address.
My pet lives at a different location.
If your pet lives at a different location, what is the name of the facility (Third Pet)?
If it is a residential home, please list "residence" above.
How did you hear about us? Please select one option below.
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Employee
Facebook/Social Media
Family/Friend
Internet Search
Local Event
Print Advertisement
Referring Veterinarian
Walked/Drove Past
Word of Mouth
Other
Please select your availability for an appointment:
Please select the day(s)of the week that work best for you (select all that apply):
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Monday
Tuesday
Wednesday
Thursday
Friday
What time of day works best for you?
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Anytime
Morning
Afternoon
Please explain the reason for this appointment:
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Please be as specific as possible and enter any additional details or requests you have.
Pet's Referring or Primary Veterinarian
Were you referred to us by another veterinarian?
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Please Select
Yes
No
What is the name of the veterinary clinic that referred your pet?
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If your pet was not referred, enter "N/A".
Please list the city and state the practice is located in?
What is the name of your pet's primary veterinary clinic
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If your pet does not have a primary veterinarian, enter "N/A".
Please list the city and state the practice is located in?
Please upload your pet's records below.
Browse Files
Drag and drop files here
Choose a file
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A member of our team will reach out to schedule your pet's appointment. What is your preferred contact method?
*
Please Select
Email
Phone
Either
I fully understand that this form is for non-urgent appointment requests only, and I confirm that my pet is not in need of urgent or emergent medical care. I understand that a reply to this appointment request can take up to 48 business hrs.
*
Please Select
Yes
***If your pet is experiencing a medical emergency, please contact us directly at 833-888-5760 ***
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