Brunswick, ME

Curbside Check-In Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at for a faster response.

Appointment

Curbside Check In Form

I am in this vehicle: *

(please list model & color)

Best Phone number for today's appointment: *

(the Veterinarian and technician will use this number to communicate with you through the appointment.)

Best email for communication about today's appointment *

Would you like to be present for todays appointment or wait outside? *

Present
Wait outside

Patient's Name *

Patient's Species *

Canine
Feline
Other

Please specify species *

Owner's Name *

First

Last

Appointment Date/Time *

Date

Time

Primary Reason for Today's Appointment *

Concern
Wellness

Please explain your concern in detail below. *

Did you bring a urine or fecal sample for your pet? *

Feces
Urine
None

Would you like wellness lab work done on your pet today?

What is your primary concern? *

Do you have any other questions for the doctor today?

What are your questions for the doctor? *

Patient's Energy Level

Normal
Increased
Decreased

List medications your pet is currently taking

Do you need refills on prescription pet food of any of these medications?

If you need a medication refill, please list which medications

If you need a prescription pet food refill, please let us know which kind

Patient's Appetite

Normal
Increased
Decreased

Drinking / Water Intake

Normal
Increased
Decreased

Any coughing, sneezing, vomiting or diarrhea? *

Coughing
Sneezing
Vomiting
Diarrhea
None of the above

Please upload any relevant records or photos below

Click or drag files to this area to upload. You can upload up to 5 files.

Phone

Vet2pet

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We’re Excited to Meet You

When you are looking for veterinary care for your pet, superior care and excellent service are what matter most. Schedule an appointment with us today!

APPOINTMENT