Clays Mill Vet Clinic Check-in Form

If you have any questions about this form call or text the clinic at 859-223-5215.

Name *

First Name Last Name

Pet's name *

Email *

example@example.com

What is the date of your appointment? (It's okay if you don't remember, just put as close as you can.) *

Date

Reason for visit (Check all that apply) *

Vaccines/Routine Health Exam Routine/Recheck bloodwork Medical Problem Nail Trim Other

If we are seeing your pet for a medical problem, please describe. Use as much detail as you would like.

Which flea/heartworm medicine is your pet on? Please check all that apply. If none check "None." *

Heartgard Sentinel Proheart (the six month injection) Nexgard Revolution Frontline Something, but I can't remember the name None

Refills: If you need any flea, heartworm, or other medication refills let us know and we will go ahead and get them ready for you. If you don't need any, write "None." *

List any other medications your pet is taking, including over-the-counter meds and supplements. If you're not at home and can't remember, that's okay. Just fill out the best you can. If none, please write "None." *

What food does your pet eat? *

May we call or text you if we have any questions after reading this form? *

Yes, I prefer text Yes, I prefer a phone call Yes, either text or phone call is fine No, I will be unavailable

If yes, what number?

COVID Protocol: Check all boxes and then sign in the question below *

I understand that CMVC is curbside and I will not attempt to enter the building. I must wear a mask at all times when interacting with staff I will not approach staff outside unless asked. If I have a question about my wait time or anything else, I will call or text the office number instead If I am having symptoms of, have been exposed to, or am under quarantine for COVID I will call and inform Clays Mill Vet Clinic BEFORE I come for my appointment.

By signing this I confirm that I understand the COVID protocol *

Clear

For your appointment, pull into a parking spot and text or call to tell us that you are at the clinic at our regular number (859-223-5215) and tell us your parking spot number. If you have any questions or comments, please put them here.

As always, you are welcome to call or text the office at any time with questions.

We would love to have a favorite picture of your pet! Please upload a picture if you have time. It will upload easily right from your phone or computer and just takes a few seconds. Thank you!!

Browse Files

Thank you!!

Arrival Procedure

It's easy!

Don't forget your phone :-)

Just call or text to let us know you are in the parking lot and we will check you in over the phone. You can text our regular clinic number 859-223-5215.

We will let you know when we're on our way out to get your pet. We prefer to exchange the pets in the open air, so just make sure pet is secure on its leash or it its carrier and step out of your car. We'll get them from you in the parking lot. We may wave but not hesitate or talk so exposure is reduced. Make sure you have your mask on.

You will wait in your car for the exam. Please feel free to call or text any time while you are waiting if you need anything.

The doctor will call you to go over the appointment in its entirety, answer any questions, etc.

When you are ready to go, the doctor will transer you to reception to check out. We are only accepting payment over the phone with credit and debit cards.

No cash or checks at this time.

We miss seeing everyone! We know these are difficult and unusual circumstances and it can be hard to not be physically present for the appointment. Email or text is a great way to keep in touch and ask any quesitons that come up after your appointment. Stay safe and healthy everyone!

Hello and welcome!