Medical Appointment Form

9501 Lakeview Parkway
(Across from LakePointe Hospital)
Rowlett, TX 75088
972-412-0101
Text 972-805-1451

Hours

Mon - Fri:
7 AM - 7 PM

Sat:
8 AM - 2 PM

*Required information.

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This form is for scheduling an appointment with Animal Hospital of Rowlett Please complete the form below, providing us with all requested information along with your three appointment time preferences. We will review your appointment request during normal business hours and compare it to our existing appointment availability. Your three time preferences will be addressed in chronological order and you will be assigned the first available time slot. If you are not notified within 1 working day of the submission of this form, please call us at 972-412-0101. If you have an emergency medical situation please call your veterinarian immediately! Do not make an on-line appointment for a veterinary emergency! * = required information
First Name: *
Last Name: *
Address: *
City *
Zip Code *
Phone number: *
E-mail address: *

Your Pet's Name

Pet species: *

Breed:

Pet's Age:

Pet's Weight

Color:

Your Pet's Sex

Date of birth:

Do you have more than one pet to be seen?

If yes, how many additional? Please also provide breed, age, and any issues with that pet.

Desired date of appointment:
Select your first preferred time of appointment
Select your second preferred time of appointment
Select your third preferred time of appointment
Do you have a doctor preference?
If yes, please make your first choice:
If yes, please make your second choice:
Services Requested: *
Special Considerations:
Notice: Your appointment is not confirmed until you have been notified by a staff member. We will compare your requested time slots with our appointment availability and notify you of your appointment.

How did you hear about us?: