Curbside Appointment Check-In

Curbside Appointment Check-In

Thank you for choosing AVVH! To insure the best care possible, please fill out this form in its entirety. Thank you!
Pet Owners Name*

First NameLast Name
Pet's Name*
Who has brought the pet in today?*

"Pet Owner" listed aboveSomeone else
Name of person bringing in pet today*

First NameLast Name
Are you responsible for authorization of treatment for the above mentioned pet?*

YesNo
Name of person responsible for authorization of treatment*

First NameLast Name
Phone number of responsible party to be reached at for today's visit *
Secondary Phone Number (optional)
Does your pet have an appointment today?*

YesNo
What time is the appointment scheduled?

Hour Minutes

AM/PM Option
Actual check in time

Hour Minutes

AM/PM Option
Please note there may be a longer wait for walk-in appointments. To avoid this wait in the future, please call to schedule an appointment for your pet. Thank you for your patience.
Please provide a brief description of why your pet is here today
Will you be waiting in your vehicle for your pet or dropping off?*

Waiting in my vehicleDropping off
Car Description (color/make/model)
What number should we call while pet is dropped off?

Number listed aboveA different phone number
Phone number
Please enter a valid phone number.
Does your pet need and food or medication refills during their visit?

YesNo
Please list any foods or refills your pet needs
Is there anything we should keep in mind when working with your pet? (i.e. deaf, blind, dog aggressive...)
Should be Empty: