Coastal Valley Veterinary Services, LLC | Old Lyme

HOURS

Appointments are available Monday through Friday from 9:30 am until 4:30 pm; later or earlier appointments can often be accommodated depending on availability. Weekend appointments are reserved for emergencies and urgent care, including hospice and at-home euthanasia. Emergency coverage is provided for current clients and patients, though you do not need to be a current client to schedule at-home euthanasia. Please call (860) 867-6367 or click below for an appointment.

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Coastal Valley Veterinary Services

PO Box 1015
Old Lyme, CT 06371

(860)867-6367

www.coastalvalleyvet.com

New Client Check In

If you would like to make an appointment, you can assist us to expedite your check in by submitting this form.

Thank you for your cooperation in letting us assist you.

New Client

Name (required)

First Name (required)	Last Name (required)

Address (required)
Street Address (required)

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Daytime Phone (required)
Phone Type	Phone Number (required)

Evening Phone (required)
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E-Mail Address :

Pet's Name (required)

Age: Years, Months (or date of birth if known)

Species (required) :

Breed:

Sex: (required)

Male
Female

Neutered/Spayed

Neutered
Spayed

Are vaccines current?

Do you have medical records?

Medical records at another Veterinary Practice?

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Name of former Veterinary Practice

May we request a transfer of records?

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reasons or conditions that prompted your visit?

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Please list any additional animals here

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