Request an Appointment | Fairfield Animal Hospital

PLEASE NOTE: This form is only for requesting an appointment, not actually booking one. A staff member will get in touch to confirm the date and time. If you have a pet emergency, please call us immediately at xxx-xxx-xxxx during business hours, or an emergency veterinarian hospital after hours.

Desired Appointment Date:

Select a time:

Preferred Vet:

Your First Name:

Your Last Name:

Phone:

Email:

How should we contact you?

Your Pet's Name:

Type of Pet:

Reason for Your Appointment:

Please prove you are human by selecting the Tree.

Please leave this field empty.