Appointments can be made by calling our office at 662.234.2928.  We also offer an on-line appointment process for your convenience.  Requests for appointments submitted on-line are reviewed during our normal business hours.  We will try to respond within one business day.  If a response is not received within your desired time frame, please call us at our business number.

Do not use this form for urgent after-hours situations; call us at our business number - 234.2928 - if your pet requires after-hours treatment.

Appointments are not made until confirmed by a staff member of Crossroads Animal Hospital.  Please provide a phone number or e-mail address so that we may contact you for confirmation of your appointment.

* designates a required field

OWNER INFORMATION:

Name:*
Address:
City, State and Zip:
Home Phone:
Work Phone:
Email Address:

 

PET INFORMATION:

Pet's Name:*
Species:	Cat    Dog    Other
Sex:	Male    Female    Neutered Male    Spayed Female    Unknown

 

SERVICES SOUGHT:

Annual Exam	Spay/Neuter
Follow-up Exam	Vaccinations
Dental Exam	Other
Heartworm Exam

Preferred Veterinarian:	Harry Fyke, DVM Katherine Kvam, DVM Whitney Rayner, DVM No Preference
Date Requested:*
Time Requested:*
Comments:	Please provide any additional information that you believe will help us care for your pet.
Confirm by:*	Work Phone Home Phone Email

 

PRIVACY STATEMENT:

We promise that we will use the information you provide only for the purposes you authorize, and that we will not share your information with any one else. We will, of course, use the information to keep your pet's records current.

We may, from time to time, distribute newsletters by email. Would you like for your email address to be added to our mailing list?     Yes, please add me to your newsletter list. No thank you. I get enough mail.