Pet Owner Name *

First

Last

Customer type *

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Pet Name *

Pet Breed *

Pet Age/Date of Birth *

Pet Gender *

Male
Male Neutered
Female
Female Spayed

Name of Your Current Veterinary Hospital *

Current Veterinary Hospital Phone Number *

Preferred appointment location?

Monday PM - Black River Veterinary Hospital, Chester NJ
Tuesday - South Branch Veterinary Services, South Lebanon NJ
Wednesday - Bridgewater Veterinary Hospital, Bridgewater NJ
Thursday AM - Stockton Veterinary Hospital, Stockton NJ
Thursday PM - Belle Mead Animal Hospital, Hillsborough NJ

*PVS operates 8-6 Monday-Thursday

Pet diagnosis or any information you would like us to know.

Diagnosis: Cytology/Biopsy Results

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Recent 6 Month Medical History

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Blood Work or Imaging

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Appointment Policy: Our goal is to provide excellent care to each patient in a timely manner. If it is necessary to cancel or reschedule an appointment, clients are required to call or leave a message at least 24 hours before their pet’s appointment time. Notification allows us time to help other pets in need of cancer care.

No-Show, Late, & Cancellation Policy

Description
“No Show” shall mean any patient who fails to arrive for a scheduled appointment. “Same Day Cancellation” shall mean any client who cancels or reschedules an appointment less than 24 hours before their scheduled appointment. No-Show and Same Day Cancellation are both considered missed appointments. “Late Arrival” shall mean any patient who arrives at the clinic 5 minutes after the expected arrival time for the scheduled appointment.

Policy
It is the policy of the practice to monitor and manage appointment no-shows and late cancellations. Private Veterinary Specialties' goal is to provide excellent care to each patient in a timely manner. If it is necessary to cancel or reschedule an appointment, clients are required to call or leave a message at least 24 hours before their pet’s appointment time. Notification allows the practice to utilize appointments for other pets in need of prompt medical care.

Procedure

A client is notified of the appointment “No-Show, Late, & Cancellation Policy” here or at the time of scheduling. This policy can and will be provided in writing to patients at their request.
Appointments must be cancelled or rescheduled at least 24 hours prior to the scheduled appointment time.
In the event a patient arrives late as defined by “late arrival” to their appointment, there will be a late fee added to their visit in the event they can still be seen. If they cannot be seen they will be rescheduled for a future appointment time.
In the event a patient has incurred one (1) documented “no-shows” and/or “same-day cancellations,” the patient may be subject to a missed appointment fee or to dismissal from Private Veterinary Specialties care.

Policy Agreement *

I have read and agree to the above policies.

Contact Private Veterinary Specialties

Appointment Request

Our Convenient Locations Around Central New Jersey