Long Lake Curbside Appointments

1

Due to the COVID-19 prevalence, we want to ensure your safety and that of our team. Please answer yes/no to these questions:
*Please note: Answering yes does NOT prohibit your pet from being seen if they are ill but allows us to put appropriate safety parameters in place for our team and doctors.

2

Do you, or someone in your household, have symptoms consistent with COVID-19, a fever, cough or difficulty breathing?* This field is required.

Yes

No

3

Have you, or someone in your household, been exposed to someone who has tested positive for COVID-19?* This field is required.

Yes

No

4

If the answer is yes to either of the above questions, we may need to reschedule your appointment. Please call us 947-2365! We are using AIRVET (a telemedicine app) to help see pets, this may be an option for you. If we feel the pet NEEDS to be seen, we will let you know and will ask for an unaffected person to bring them if possible.

5

Your Name* This field is required.

First Name

Last Name

6

Pet's Name* This field is required.

7

Cell Phone Number you will have at your visit* This field is required.

Area Code

Phone Number

8

Email* This field is required.

example@example.com

9

Appointment Date* This field is required.

Date

10

Brieﬂy describe the reason your pet is here for an exam, such as ear infection, sick or limping. Please answer ALL QUESTIONS below regardless of why your pet is here.

11

Has your pet been coughing?* This field is required.

Yes

No

12

Has your pet been sneezing?* This field is required.

Yes

No

13

Does your pet have any nasal discharge? If yes, please describe the color and which nostril(s).

14

Has your pet been vomiting? If yes, when was the last time and describe the vomit.

15

Has your pet had diarrhea?* This field is required.

Yes

No

16

If your pet's stool does not look normal, is it black or bloody? When was the last time you saw a bowel movement?

17

Has your pet been drinking more?* This field is required.

Yes

No

18

Has your pet has been urinating more? If so, what was the color and amount?

19

What do you feed your pet?

20

If your pet's appetite has changed, please describe how so.

21

If your pet's diet has recently changed please share when and what did you change in their diet?

22

If your pet is lethargic, how long have they been lethargic for?

23

If your pet is limping, how long has your pet been limping, and which leg for how long?

24

Please list all medications your pet is on and when they were last given.* This field is required.

25

If your pet has cried out, please share what your pet was doing

26

If your pet has problems with one or both of their eyes, please describe any drainage, symptoms, and which eye.

27

If your pet has problems with one or both of their ears, describe any discharge, symptoms, and which ear.

28

If you have any concerns with your pet's teeth, please describe.

29

Would you like your pet’s nails trimmed while here?* This field is required.

Yes

No

30

If there are if any concerns with the nails, please describe.

31

Would you like your pet’s anal glands emptied?* This field is required.

Yes

No

32

Are there any concerns about your pet's anal glands? Any scooting or licking, please describe.

33

Are there any new lumps or bumps you have found? If so, please describe where, and when it was noticed?

34

Please use this comment section to include any questions or concerns you have. Please also include any information that you feel would be helpful in treating your pet today. We will do our best to have your pet seen and communicate a plan as quickly as possible.

35

For wellness exams we recommend annual bloodwork. We will call you with the bloodwork choices and cost if you would like to proceed. Blood work is discounted if you need a heartworm test or fecal at the same time.

36

Would you like bloodwork today for your pet?

Yes

No

37

If you need any medication or food refills, please list what and how many.

38

If your pet has a current heartworm test are you requesting HEARTGARD PLUS today? We do have rebates again this year! If so, how many?

39

All dogs need ﬂea/tick prevention. We carry two options: NEXGARD (chewable) and FRONTLINE GOLD(topical). Do you need some? If so, which kind and how many?

40

All cats need parasite prevention, we have REVOLUTION PLUS(topical all in one) or HEARTGARD(oral)and FRONTLINE GOLD(topical) as a combination product. Do you need some? If so, which one and how many?

41

PLEASE GO AHEAD WITH DIAGNOSTICS AND TREATMENTS IF THE COSTS ARE NOT OVER $350. WE WILL CALL YOU IF WE ARE EXPECTING COSTS TO GO OVER $350, OR IF YOU HAVE CHECKED NO.* This field is required.

Yes

No

42

Curbside appointments must arrive 10 minutes prior to appointment. If you are scheduled for a routine annual exam, we recommend yearly blood work and viral screening, fecals checked twice yearly, and vaccines due updated. We will provide an estimate of what we have in our records that are needed for your pet for your review.

Please have your pet on a leash or in a carrier before we come to the car. You will be given a slip leash to put on your dog. Please get out of your car to hand the leash to our team member.

Please text our ofﬁce (231) 409-7566 when you arrive with your name, space, and purpose. If you can not text, call our ofﬁce once you have arrived (231) 947-2365.
Note: Our cell phone is only for texting your arrival. Please do not call the cell number or ask questions via text, as they will not be answered.

Please bring a fecal and urine sample, so if needed, it is available.

43

I authorize curbside service and care of my pet by the veterinarians and the team of Long Lake Animal Hospital. I understand my pet will be accompanied by a team member during their visit, rather than myself. Further medical authorization of recommended treatment(s) will be done via phone communication; I consent to over the phone financial and treatment authorization.

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