Blog - Neighbourhood Pet Clinic

Independently & Locally-Owned

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Call (519) 649-0080

for any of our four locations.

Appointment Request

Client Type:

New Client
Existing Client

Name *

First

Last

Email *

Phone *

Is this number a home phone or cell phone? *

Home Phone
Cell Phone

Cell Phone

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Preferred Method of Contact:

Email
Phone

Secondary Contact Name

First

Last

Secondary Contact Phone

Is this secondary contact your spouse?

Yes - this person will share my account
No - Please add as emergency contact only
Other - please specify

If other, please specify: *

Name of Your Furry Family Member: *

Species: *

Dog
Cat

Pet's Breed *

Pet's Colouring *

Sex *

Male
Neutered Male
Female
Spayed Female

Pet's Age / Date of Birth

Do you have a previous veterinarian? *

Yes
No

Previous Veterinarian's Name *

Clinic Location *

Preferred Appointment Day(s): *

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Our current schedule is as follows: Mon - Fri: 8 AM - 7 PM Sat: 9 AM - 4 PM

Preferred Appointment Time: *

9:00 AM - 12:00 PM
12:00 PM - 3:00 PM
3:00 PM - 6:00 PM

Our current schedule is as follows: Mon - Fri: 8 AM - 7 PM Sat: 9 AM - 4 PM

Reason for appointment: *

Comment

Four Locations + Pet Shuttle Serving London, Ontario
Mailing Address: 746 Waterloo St, London Ontario N6A 3W3

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