This field is for validation purposes and should be left unchanged.

Please complete the following form to request an appointment. Please also note that availability will vary depending on your request. A member of our staff will reach out by phone or email. Thank you!

Are you a new client?*

Yes
No

Where was your pet last seen by a veterinarian (New clients-please list your previous veterinarian and contact information so we can have your records sent over prior to your appointment, Current patients-please list if another veterinarian other than NoVa Mobile Vet has seen your pet recently)*

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Best Contact Number*

Email*

Is the address above the address as where the appointment will be scheduled? (If no, please fill in address where we will be visiting your pet)*

Pet Name*

Pet age or date of birth*

Pet breed*

Pet gender*

Is your pet spayed/neutered?

Yes
No

Please indicate any history of anxiety or aggression towards people (this will determine how we should schedule your appointment)*

Are you able to muzzle your dog if requested?*

Yes
No
Not applicable

Are you able to isolate your cat into a bathroom/office prior to our arrival?*

Yes
No
Not applicable

Please give a brief description of the appointment type or concerns for your pet?*

We warmly welcome new clients for compassionate in-home euthanasia.
Routine mobile care is limited to current clients, while new patients are always welcome at our office

Say goodbye with dignity, comfort, and love. Book and in-home visit now.

New Client Appointments