Milan Veterinary Clinic

PO Box 267
Milan, MI 48160

(734)439-1112

www.milanvetclinic.com

Request Appointment Form

Name
First Name
Last Name
Phone
Phone TypePhone Number
E-Mail Address (required) :
Patient Type (required)

New Patient
Current Patient


Please select times that you have available so that we can schedule your appointment.
Appointment Date & Time 1st Choice (required) :
Appointment Date & Time 2nd Choice (required) :
Best Method for Confirming Appointment (required)

Phone
Email


What type of appointment is needed, Vaccinations, Tests, Surgery or Dental, Injury or Illness? (required)


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