Affordable Vet Services


SHOP THE ONLINE STORE NOW
Log into your PetPortal
(If you don't have a PetPortal just e-mail us and we can set one up)

   






Affordable Vet Services
611 South Ashley St
Ann Arbor, MI 48103
(734)926-0114

Dr. Bill MacArthur

Dr. Maja Fontichiaro

Dr. Shana Burack

Dr. Richard Ham

Hours

Monday 9:30-5:30

Tuesday 9:30-7:30

Wednesday 9:30-5:30

Thursday 9:30-5:30

Friday 9:30-5:30

Open one Saturday a month, check the website for dates

Find us on Facebook

New Client Check In

If you would like to make an appointment, you can assist us to expedite your check in by submitting this form.  If you have more than one animal you would like to bring in, please submit one form for each of them.

Thank you for your cooporation in letting us assist you.

Form - New Client

Name & Email (required)
First Name (required)
Last Name (required)
Address (required)
Street Address (required)
City (required)
State/Province (required)
Zip/Postal Code (required)
,
Daytime Phone (required)
Phone TypePhone Number (required)
Evening Phone (required)
Phone TypePhone Number (required)
E-Mail Address :
Pet's Name (required)

Birthdate (if known)

Age: Years, Months

Type of Pet (required) :
Breed:

Color

Sex: (required)
Male
Female

Neutered/Spayed
Neutered
Spayed

Are your pets vaccines current?
Do you have pets medical records?
Medical records at another veterinary Practice?
Yes
No

Name of Former Veterinary Practice

May we request a transfer of records?
Yes
No

Would you like us to call you for your appointment
Reasons or conditions that prompted your visit?

Special requests or conditions?

Please list any additional pets here

Please Read
I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Affordable Vet Services and that charges are due and payable at the time of service, unless other arrangements are made in advance. Any balance that is carried over a period of 30 days will accrue a monthly finance charge. Any balance that I leave unpaid will be forwarded to Affordable Vet Services's collection agency, and will incur a 25% collection fee for which I am liable, in addition to monthly finance charges.
I have read this statement and - (required)
I Agree
I Disagree


The verification code below ensures the form is not submitted by a computer
Verification Code :
Enter the code you see in the graphic below in this box.
Your post will not be allowed if you do not type this in correctly.