Telemedicine Appointment Request

Please fill out this form as completely as possible to request a telemedicine appointment. Please contact us with any questions.

"*" indicates required fields

Owner's Name*
How Would You Like to be Contacted?*
I am a current client of KPAH. I authorize the veterinarian on call today to access my pet’s records to be able to make timely and accurate recommendations for my pet.*
Upload pictures to give your doctor the best chance to help you and your pet.
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Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 15 MB.
    Service Requested