540-382-1100 appalachianvetservice@gmail.com

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Curbside Check-In

Please fill out the curbside check-in form below, and a member of our team will get back to you shortly. If you have any questions, please feel free to contact us.

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Welcome

Please note any fields with * are required.

I am in this vehicle: *

(Please list the model & color.)

Best Phone number for today's appointment: *

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

Email *

Patient's Name *

Patient's Species *

Canine
Feline

Owner's Name *

First

Last

Appointment Date / Time *

Date

Time

Primary Reason for Appointment / Concern (please be as detailed as possible) *

Patient's Energy Level

Normal
Increased
Decreased

Please list medications your pet is currently taking. If not taking any, please write N/A.

Do you need refills of any of these medications?

Yes
No

If you need a medication refill, please list which medications.

Do you need refills on any prescription pet food?

Yes
No

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

Is the patient coughing?

Yes
No

If yes, for how long?

Is the patient sneezing?

Yes
No

If yes, for how long?

Is the patient vomiting?

Yes
No

If yes, for how long?

Are your pet’s bowel movements normal or abnormal?

Normal
Abnormal

(Please note: Normal feces is solid logs {think tootsie roll candy} that are not too hard and easy to pick up. Anything else is not normal though your pet may have a different type of bowel movement that is all you’ve seen from them.)

Please describe feces (if not normal).

What are you feeding your pet (brand, wet or dry, etc)? Please be specific if possible & include how much you feed and how often each day you feed.

If you have a kitty, please let us know if kitty is indoors exclusively, outdoors exclusively or both in and outside. You can provide more information if you wish such as “only goes out on the patio when I’m with her."

I understand that financial responsibility for services rendered are payable at the time of discharge. I have reviewed the treatment plan and estimate provided to me by Appalachian Veterinary Services staff and my signature below indicates my approval of the treatment plan. *

I have read and understand.

Please upload any relevant photos, videos, or records here:

Click or drag a file to this area to upload.

Please upload any additional relevant photos, videos, or records here:

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Please upload any additional relevant photos, videos, or records here:

Click or drag a file to this area to upload.

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Small Animal Surgery

Coming soon! Please check back in or submit your information to be alerted when we start scheduling surgical procedures!

You will be able to schedule all of your pet's surgical needs with Appalachian, such as:

Canine and feline spay/neuter
Cancerous mass surgery
Foreign body surgery
Feline bladder stone surgery
Severe wound reconstruction
Prophylactic dental cleanings
Dental radiography and tooth extractions

Name *

First

Last

Email *

Phone

How can we help you? *

Phone

Let’s Talk!

Please don’t hesitate to reach out with the contact information below, or send a message using the form.

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Address

Physical Location:
1511 Flanagan Dr.
Christiansburg, VA 24073

Mailing:
PO Box 174
Riner, VA 24149

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Phone

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Email

appalachianvetservice@gmail.com

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