Appointment Request

Please use the form below to request an appointment. One of our team members will call you back to confirm your appointment at Lance Animal Hospital.

Your First Name (required)

Your Last Name (required)

First Preferred Appointment Date (required)

 Morning Afternoon Evening

Second Preferred Appointment Date (required)

 Morning Afternoon Evening

Third Preferred Appointment Date

 Morning Afternoon Evening

Please provide us with a phone number so we can call to confirm your appointment.

Your Phone Number (required)

Alternate Phone Number

Your Email Address (required)

Reason for Appointment

Your Pet's Name (required)

Your Pet's Age

Pet Type

Other Additional Information

Are you currently a client of Lance Animal Hospital?
 Yes No

Incase of an emergency, please call us right away at 770-503-PETS (7387).
To change your appointment please call us 24hours before your scheduled appointment time.