Request Appointment - Elgin Veterinary Hospital

Appointment Request Form

Elgin Veterinary Hospital
If you would like to request an appointment at our hospital, please fill out and submit the form below.

Please note that this is only a request, someone from our office will contact you shortly to confirm a date and time for your appointment.

For new patients, please allow an additional 10 to 15 minutes prior to your appointment to create a medical record and patient file.
Name*

First NameLast Name
Email*
[email protected]
Phone Number*
Please enter a valid phone number.
Animal’s Name*
Animal Breed*
Department*

EquineBovine
Preferred Veterinarian
Preferred Date*
Preferred Time*

MorningAfternoonEveningNo Preference
What is the reason for your visit?*
Should be Empty:

Appointment Request Form