Feline Pre-exam Form

Feline Exam Form
Due to COVID-19, we are only offering curbside services. To help the check-in flow and to minimize wait time, please complete this form prior to your arrival.

We have installed teller-style windows located on either side of our lobby door. Check-in is to the right of the door, check-out is to the left. Upon arrival, we ask that you come to the check-in window. Once checked-in, you will be asked to return to your car until the vet is ready. The assistant will call the cell phone number provided to review your pets visit details. When finished, they will ask you to meet them at the door. Once inside, the vet will examine your pet. Once complete, the vet will call you to review the findings and confirm treatment plan. Once the exam is complete, the vet or assistant will instruct you to come to the front for check-out. Your assistant will then bring you your pet along with any items being sent home.
Owner Name *

First Name Last Name
Cell Phone Number *

Area Code Phone Number
Email address *
Alternate Caregiver

First Name Last Name
Phone Number

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Vehicle *

Make Model
Vehicle Color *
Pet's name *
Please describe in detail the reason for your pets visit. Be as specific as possible. *
My pet lives... *

Indoor only Outdoor only Indoor/outdoor
Does your pet have any known history of anxiety, fear or aggression towards other animals, humans or places? *

Yes No
If yes, please describe
All cats entering the clinic must be in a secured carrier. If you do not have one, we can supply a cardboard carrier for $10. (If your cat is not in a secured carrier, please leave him/her in the car until we can give you a carrier) *

My cat will be in a secured carrier Please provide cardboard carrier at check-in
My pet has previous records?

Yes No
Previous veterinarian Name, Location and/or phone #?
Upload records, if available:

Browse Files

Cancel of

COVID-19 Safety Precautions and Guidelines

In order to continue caring for our local fur-babies, and for the safety of our staff; we have implemented the following guidelines.
As per NC Regulations, and for the safety of our staff, mask are REQUIRED when interacting face-to-face with our staff, especially when exchanging pet. Our health and well-being is imperitive for us to continue serving the community. ACV staff has been directed not to interact with unmasked clients. They are also advised not to reach or get into vehicles.
I agree to wear a face mask and maintain 6 feet social distancing as much as possible while in the presence of ACV staff. *

I agree I refuse to wear a mask and wish to reschedule my appointment.
Are you or any of your household member(s) currently COVID positive, presumed positive or have any recent exposures that may pose risk to our staff? *

Presumed/Positive under isolation or quarantine Experiencing COVID symptoms/Known exposure Caring for COVID patient No know exposure or symptoms
If you are currently experiencing a COVID related situation, and your pet is in need of urgent medical attention, please contact our office directly to discuss how we can safely provide care for your pet. 910-399-2934.
Should be Empty:

Feline Exam Form

Preventative Care

Rabies Vaccine

FVRCP Combination Vaccine ($28)

Leukemia Vaccine ($28)

Felv/Fiv Combo Test ($39)

Fecal Parasite Testing ($20 or complimentary with exam)

COVID-19 Safety Precautions and Guidelines