Let’s keep in touch!

Scroll down for new patient registration. Click here for medication or food refill requests.

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Name *

Phone *

Email Address *

Your Message *

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Click here for medication or food refill requests.

By providing a telephone number and submitting this form you are consenting to be contacted by SMS text message. Message & data rates may apply. You can reply STOP to opt-out of further messaging.

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Name *

First

Last

Pet's Name *

Pet's breed and gender *

Pet's Year of Birth *

If you do not know the exact date of birth, please provide an estimate

Reason for consultation *Wellness visitAcupunctureChronic IllnessCancer CareDiagnostic Testing

If your pet has a chronic illness, please provide the diagnosis or a brief summary of symptoms if no diagnosis has been made yet:

Do you have a preference for a specific day of the week and/or time of day?

Veterinarian preference *Book my pet in the soonest available timeslot pleaseDr. Victoria TongDr. Cindy KneeboneDr. Rona Sherebrin PLEASE NOTE: Dr. Sherebrin has a waiting list for new patients, however existing patients may be scheduled with her for follow up visits and internal consultations.

Email *

Phone number (mobile/cell) *

Alternate phone number (home/work)

Hospital Policy *

• I have read and agree to all Hospital Policies

A link to our hospital policy can also be found at the bottom of our home page.

Request New Patient Appointment

By providing a telephone number and submitting this form you are consenting to be contacted by SMS text message. Message & data rates may apply. You can reply STOP to opt-out of further messaging.

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Name *

First

Last

Email *

Pet name? *

Please select your product *– Please select –Prescription dietMaintenance dietPrescription pharmaceutical medicationPrescription herbal or nutritional supplementOther

Please select how quickly it is required: *– Please select –Urgently! I'm completely out and need it today. I understand there will be a $15 urgent refill fee added to the invoice.In a few days (4-7 business days advance notice)Next week (Way to go, you are planning ahead!)

Product name and details (size/strength)? *

Please give as much detail as possible, eg tablet size in mg; include Rx number if present on the item’s hospital dispensing label

Amount/size required? *

Please specify number of tablets, size of bottle in ml or grams, or number of vials or ampules

Additonal information or comments:

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