Test form – Pet Health Care Long Island, NY

Make an Appointment (New and Returning Customers)

We are happy to book an appointment for you. This is not an automatic process. Once we receive your request, we will contact you to confirm a date and time that is as close to your request as possible.

This form should only be used for requesting future appointments and not appropriate for emergency situations

If your appointment has not been confirmed within 24 hours, please feel free to contact the practice by phone to confirm.

Name*
First Last
Email*
Phone*
Pet Name*
New to Pet Health Centers?*
Customer ID
If available, please enter your customer ID. It would be listed on the top left of any past invoice.
Preferred Date*
Enter as “MM/DD/YYYY”
Date Format: MM slash DD slash YYYY
Preferred Time*

: HH

MM
Reason for appointment*

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Make an Appointment (New and Returning Customers)

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