Curbside Check-In Form

Thank you for partaking in our Pet Valet Service!

During the Covid-19 Challenge, we are taking patients in through Curbside Check-In in order to minimize the number of people in the building, to help us all engage in appropriate social distancing. This helps keep you safe and helps keep us safer so we can be here for you! We understand that you may have concerns about your pet coming into the building without you, but we can tell you that most have been doing just great! We do encourage Kitty and Canine Calming Kits (medication to calm your pet). Call Us if you are interested! We ask that Pet Parents stay in their cars when possible. Call us if you need anything and we will help! We understand that it's getting HOT outside, so you can drop your pet off, by filling out this form! Please participate in a couple Family Wellness Screening questions for everyone's safety.

For anesthetic cases*

I authorize the use of appropriate anesthetics and other medications. I understand that during this procedure(s), unforeseen conditions may be revealed that necessitate an extension of the same or different procedure(s) than set forth above. I also understand that, despite pre-surgical exams and diagnostics, unforseen conditions may exist that may cause unexpected anesthetic complications. I authorize the Doctors and Staff to do everything within their power to prevent anesthetic complications.
Please check all that apply

MEDICAL HISTORY

Please fill in the health questions below so we can be sure to cover everything while your pet is here. This also helps us keep your pet's record up to date between visits!
Please check all that apply
Please check all that apply

Please list an Medications, Supplements your pet is Currently Taking*

Remember Heartworm Preventives, Flea/Tick Protection, Vitamins and Natural supplements

Contact information

Preferred Method of Communication Today*

It is CRITICAL that we have contact information so that you can be reached while your pet is here.

Consent

By Typing my Name Below I allow the procedures that I have requested above to performed on my pet in my absence. I understand that I will be charged a $15.00 Kennel fee if my pet is left at the clinic after my arranged pick up time.*