Request an Appointment

Your First Name:
Your Last Name:
Your Address:
City:
State:
ZIP Code:
Your Daytime Phone:
Your Evening Phone:
Your Email:
Your Pet's Name

What type of animal is your pet?
Your Pet's sex:
Is your pet neutered?
Your pet's color:
Other (Species):
Breed:
Body weight (pounds):
Age of your pet:

Hours of Operation:
Dental: 9-5 M-F
Gen-Med: 11am - 7pm Mon
9am - 5pm Tues, Wed, Fri
2pm - 7pm Thurs
9am - 12pm every other Saturday

5300 Plymouth Rd
Ann Arbor, MI 48105
Get Directions
Phone: (734) 975-1623
Fax: (734) 929-6632

Reason for Appointment: Check all that apply.
Well Animal Exam	Vaccination (bring fecal sample)
Coughing	Sneezing
Limping / unable to walk	Weight loss/gain
Oral Problems (Request Dr. Colmery)	Vomiting and/or diarrhea
Heartworm Test	Itching/hair loss
Excessive urination or drinking	Eye Problems
Ear Problems
Urgency:

Additional comments or problems:

Has your pet ever had dental work before? Yes No
if so, what was done, and did it help?

Would you like to schedule an appointment with Dr. Colmery? Yes No