COVID APPT CHECK IN

COVID APPOINTMENT CHECK-IN FORM

* Indicates required field

Name *

First

Last

Pet's Name *

Reason for visit and any questions you have for the veterinarian: *

Please list all of your pet's medications, supplements and flea control *

Please tell us what food your pet eats: *

Are urination & defecation normal? *

Any vomiting or diarrhea? *

Any changes in weight? *

Any coughing or sneezing? *

We love giving out treats. Is there anything your pet can't have while with us? *

Thank you for providing us with information about your pet. It will help us streamline the curbside appointment process as much as possible. We greatly appreciate your patience and understanding with our new protocols.

I affirm that I am the owner or agent of the animal names above and I am over 18 years of age. My electronic name entry herein constitutes my legal signature and authorizes Fidalgo Animal Medical Center to examine my pet. I understand the doctor will contact me after she/he has examined my pet, to discussed their findings and recommendations. I authorize my pet to leave my custody and enter the clinic in the care of a clinic team member. Should life-saving emergency care be needed, it will be performed unless discussed prior with your care team.

Name *

First

Last

Vehicle make/model/color: *

Phone number for the doctor to call: *

Submit

COVID APPOINTMENT CHECK-IN FORM

FIDALGO ANIMAL MEDICAL CENTER

office hours

In Case of Emergency

3303 Commercial Ave
Anacortes, WA 98221
FAMC@FIDALGOVETS.COM

Our Partners in care

COVID APPOINTMENT CHECK​-IN FORM

FIDALGO ANIMAL MEDICAL CENTER

office hours

In Case of Emergency

3303 Commercial AveAnacortes, WA 98221FAMC@FIDALGOVETS.COM​​

Our Partners in care

COVID APPOINTMENT CHECK-IN FORM

3303 Commercial Ave
Anacortes, WA 98221
FAMC@FIDALGOVETS.COM