Request a Visit - Landis Vet Home Care

Request a Visit

Fill out the form below to request a visit from Dr. Landis

** NOTE: CURRENTLY DR. LORI IS NOT ACCEPTING NEW CLIENTS. CURRENT CLIENTS MAY CONTACT HER USING THIS FORM.**

Dr. Lori is only licensed to practice in Maryland so cannot perform home visits in other states. She can provide virtual consultations for out-of-state clients.

Name(*)

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Email Address(*)

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Phone Number(*)

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Home Address(*)

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Pet Name

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Species (eg Dog, Cat)

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Breed

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Age

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Weight

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Male/Female

Male

Female

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Reason for Visit(*)

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How did you hear about us?

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Regular Veterinarian

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Prefered Date/Time Visit

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(*)

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