Central Park Veterinary Clinic

252 Route 108
Somersworth, NH 03878

(603)742-1203

centralparkvet.net

Appointment Request Form

Please complete the following information so that we can best meet your appointment needs.
If your pet has an urgent medical issue, please call the office at (603) 742 - 1203 for emergency assistance.
NEW CLIENTS / NEW PATIENTS
Unfortunately, we cannot complete online appointment requests for new clients or new patients, as there is too much information we need to best fulfill your needs. If you are a new client or an existing client making an appointment for a new pet, please call the office to create your pet's file and make an appointment. Thank you!
Pet Owner Information
Owner's Name (required)
First Name (required)
Last Name (required)
Address
Street Address
City
,
State / Province
Zip / Postal Code
Phone (required)
Phone TypePhone Number (required)
E-Mail Address (required) :
Patient Information
Species (required)
(What type of pet will we be making this appointment for?)
dog
cat
other


Pet's Name (required)

Reason for Appointment (Health concerns, requested procedures, etc) (required)

Please note:
If requesting a well patient visit (healthy pet exam/vaccinations/annual visit), please tell us if there are health issues that you feel may need to be addressed at the same time. This allows us to schedule enough time to address all of your concerns. Thank you!
Appointment Day/Time Preference (required)

Thank you
We will contact you by email within one business day. We will do our best to match an available appointment with the date and time that you requested. However, please keep in mind that if the requested date/time is not available, we will offer you the closest match that we find. For routine appointments, we are generally scheduling about 2 weeks away. Thank you for choosing Central Park Veterinary Clinic. We look forward to seeing your pet soon!

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