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Curbside Pre-Visit Information

Submitting the following information prior to your appointment will help us make your curbside appointment as quick and comfortable as possible for you and your pet. When you arrive, please park in one of the numbered spaces in the lot and call the clinic from your cell phone. (Kettering: 937-435- 3262, or Springboro: 937-514-7702)

Are you or anyone in your household experiencing any of the following symptoms: fever, cough, or shortness of breath?*
- Yes
- No
Do you or anyone in your household have an active COVID infection (tested positive for COVID-19 with no subsequent negative tests), or have you been exposed to a person who has an active COVID infection (tested positive for COVID-19 with no subsequent negative tests)?*
- Yes
- No
If you answered "Yes" to either of the above questions, please explain:*
(We ask this so we can make sure to take appropriate safety precautions during your visit)
Your Name*
Your Pet's Name*
Your Cell Phone #*
Diet*
What food does your pet eat (include brand(s), formula(s) and dry/wet)?
Medications & Supplements
Please list any medications or supplements your pet is taking and indicate if you need refills:

Name Dose How Often? Need Refills?(y/n)
Heartworm Prevention

Name How Often? Need Refills?(y/n)
Flea & Tick Prevention

Name How Often? Need Refills?(y/n)
Reason for Your Visit*
Anything else we need to know about your pet or the reason for your visit?
Other Services
Any additional services you think your pet needs during the visit?
- Nail Trim (add’l $25.00)
- Anal Glands (add’l $26.00)
Curbside Reminders
• When you arrive, please park in one of the numbered spaces in the lot and call the clinic from
your cell phone. (Kettering: 937-435-3262, or Springboro: 937-514-7702).
• Make sure to bring a collar/harness and leash for your dog and/or secure carrier for your cat.
This is for your pet’s safety.
• For your safety and ours, please bring a face covering to wear when staff are bringing your pet in and out.
• Although you will remain outside the building for your appointment, we will communicate with
you throughout your pet’s visit. Please wait for your pet and be ready to answer your cell
phone while your pet is here.
• Calls from inside the clinic may not show the clinic on your Caller ID, because for outgoing calls
we use a multiline phone system and, sometimes, cell phones. During your pet’s visit, please be
prepared to answer calls even if the Caller ID shows “Unavailable” or a number you don’t
recognize.
• Credit cards are preferred for payment. We will take your payment by phone at the end of your appointment.
CAPTCHA

Name	Dose	How Often?	Need Refills?(y/n)

Name	How Often?	Need Refills?(y/n)

Name	How Often?	Need Refills?(y/n)