Your Name:

Pet's Name:

If you are a new client then please fill out the new patient information form

Email:

Phone Number:

Address (if a new client):

Location of appointment requested:House CallChristensen Animal Hospital - WilmetteOther

Date of appointment requested:

Time of appointment requested:

Services requested:

Please provide a brief summary of any concerns or issues that you would like addressed during this appointment:

Please leave this field empty.

Please allow 24 hours for confirmation of this appointment or a reply with alternative options if your requested appointment time is not available. If you have more urgent needs for your pet, please call (312) 724-7844 to reach Pets in Balance.