Global Veterinary Services
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Appointment Request Form

We will answer all e-mails within 24 hours during the week, and 36 hours on weekends. If this is an emergency, please call me at 734.812.9504.


Client Name and Phone Number:




(Please check all that apply)
   Service Requested:
Cruciate - Unilateral
Cruciate - Bilateral
TPLO
Fracture Repair
Soft Tissue Surgery
Radiology Consultation

Comments:
Patient Info
Canine
Feline

Comments (please include breed, age, name, and any other pertinent info):




Date Requested
Emergency
Within 1 week
Within 2 weeks
Within 3 weeks


Additional Comments


Your name, Hospital name, and phone number


                     


Thank You for choosing Global Veterinary Services!

e-mail:  gumbs2@msn.com    square    phone:  734.812.9504

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