Thank you for choosing Canyon Hills Animal Hospital & Internal Medicine! We're so glad to be part of your pet’s care team. To help us schedule your appointment as smoothly and quickly as possible, please take a moment to fill out the information below.

Are you a new or returning client? *

I'm a new client

I've been to Canyon Hills before

What type of visit does your pet need? *

New Internal Medicine Consultation

Internal Medicine Follow-Up or Recheck

General Medicine or Wellness Visit

Name *

First Name

Last Name

Email *

Phone

(###)

###

####

Pet's Name *

For new clients, please add pet's species, breed, color, sex, and age

Has your pet been diagnosed with any medical conditions?

Is your pet experiencing any of the following symptoms? *

Vomiting

Diarrhea/Loose Stool

Coughing or Sneezing

Difficulty Breathing/Labored Breathing

Limping or Lameness

Itching or Excessive Scratching

Change in Appetite

Increased Thirst or Urination

Lethargy

Swelling or Lumps

Shaking Head or Ear Discomfort

Behavioral Changes

Weight Loss

Weight Gain

No Current Concerns

When would you like to bring your pet in?

For urgent matters, please call us directly at (714) 692-8232.

Have more to share? Add anything you think would be helpful here.

Checking this box signifies your agreement to share your information with us in accordance with our Privacy Policy and acknowledges your understanding of how it will be used. *

I agree

We’re on it!

A member of our team will contact you as soon as possible to finalize the details of your appointment.

For urgent matters, please call us directly at (714) 692-8232.