Request Appointment | Broadview Animal Hospital

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"*" indicates required fields

Please complete the following information to request an appointment. Your appointment will be confirmed by phone by a member of our staff as soon as possible. If you are having a pet emergency do not use this form and call the hospital directly. Thank you!

Select a Location*

Pick a location. We will review your request and confirm a location with you based upon your preference and doctor availability.

Existing or New Client*

If not sure, select existing and we will double check our system.

Your Name*

Pet Name*

Do you have a previous veterinary hospital your pet(s) were patients at?*

If so, please provide the name of the hospital so we can help assist in requesting copies of their prior medical records.

New Pet

Please check the box below if this request is for a new pet.

New Pet

Species*

Canine, Feline Etc.

Sex*

Age / Date of Birth

Please provide an estimated age or date of birth if known.

Breed

Beagle, Golden, Mixed, Domestic Short Hair Etc.

Patient Color*

Please indicate the pet color(s).

Best Phone Number(s) to Reach You*

If including more than one phone number please indicate priority or any other special instructions to best reach you.

Address*

Street Address City State / Province / Region ZIP / Postal Code

Email*

Email is used for internal hospital communications only and is not solicited to outside vendors.

Enter Email Confirm Email

Please select your 1st choice date for your pets appointment.*

Please select your available timeframe for your 1st choice.*

Please select the earliest time you are available.

1st Choice Start Time

Please select the latest time you are available.

1st Choice End Time

Please select your 2nd choice date for your pets appointment.*

Please pick a different date than your 1st choice.

Please select your available timeframe for your 2nd choice.*

Please select the earliest time you are available.

2nd Choice Start Time

Please select the latest time you are available.

2nd Choice End Time

Reason for Visit*

Please provide a reason for the visit and anything else you would like share with us. If you are looking to schedule an appointment for more than one pet please include the additional pets information below instead of submitting another request. Let us know if you have a preferred doctor. DO NOT use this form for a PET EMERGENCY instead call us directly, press option 1 for prompt assistance. Thank you!

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Phone

This field is for validation purposes and should be left unchanged.

Text

Prefer not to submit the form? You may text to request an appointment to the location your are looking to visit.

Text: APPT or Schedule to 603-335-2120 (Rochester)
Text: APPT or Schedule to 603-740-1800 (Dover)
Text: APPT or Schedule to 603-652-9661 (Milton)

Call

Please to call? Please call us at 603-335-2120 (Rochester), 603-740-1800 (Dover), or 603-652-9661 (Milton) and press option 4.