Coastal Valley Veterinary Services

PO Box 1015
Old Lyme, CT 06371

(860)867-6367

www.coastalvalleyvet.com

PLEASE NOTE:

Coastal Valley Veterinary Services is currently closed to new clients. However, we are still providing at-home euthanasia services to all clients whether or not you have a pre-existing relationship with CVVS. 

This request form is NOT for emergency or urgent-care appointments!
Please call for time-sensitive requests; we are not always able to answer email immediately.
Thank you!

CVVS Appointment Request

Name (required)
First Name (required)
Last Name (required)
Contact Information (required)
Phone TypePhone Number (required)
Phone
Phone TypePhone Number
Address (required)
Street Address (required)
City (required)
,
State / Province (required)
Zip / Postal Code (required)
E-Mail Address (required) :
Contact/confirmation preference - Phone or Email
No preference
Please confirm by phone
Please confirm by email
Patient Information
Patient type
new patient **
current patient
returning patient
**NEW CLIENTS, please fill out the New Client Form** Link will be listed after you submit this form
Patient name:

Please indicate times that you have available so that we may schedule an appointment for you.
Appointment time requested, first choice :
Appointment time requested, second choice :
Appointment time requested, third choice :
Reason for appointment request

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