Curbside Check-In Form

Name: Van Crest Animal Hospital & Boarding
Address: 1817 Augusta Rd, West Columbia, SC, 29169, United States
Telephone: 803-794-6550
Price range: $

Before you come to see us, please complete your curbside check-in form online.

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Curbside Check-In Form

After check-in, please place your pet in the fenced-in area and wait with them until a team member can come out and retrieve them. During your appointment, please stay in your vehicle and keep your cell phone at hand so that we can retrieve the history on your pet in a timely manner. If you have not booked an appointment yet, please do so here:

New Client Appointment Form

Existing Client Appointment Form

Please note: Our updated COVID-19 policy requires us to let you know the symptoms to be aware of before coming into your appointment. If you are suffering from ANY of the following: coughing, fever, upper respiratory, headache, or gastrointestinal issues, any international travels, or travels by airplane to hotspots within the US, etc., your pet’s appointment will need to be rescheduled, or another person needs to bring your pet in for the appointment. A mask is always required.

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.)

Email *

Patient's Name *

Patient's Species *

Please specify

Owner's Name *

First

Last

Have you booked your appointment yet? *

If you have not booked an appointment yet, please do not fill out this form.

Appointment Date/Time *

Date

Time

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

Patient's Energy Level

Normal
Increased
Decreased

List ALL medications your pet is currently taking. Please include dosage, frequency, and any flea/tick/heartworm or over the counter (including CBD) products.

Do you need refills of any of these medications

If you need a medication refill, please list which medications

If you do not need a refill, please put N/A.

Please list what diet / food your pet currently eats (include brand & feeding schedule) and all treats and how often given.

Do you need refills on any prescription pet food?

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?

If yes, for how long?

Is the patient sneezing?

Is the patient vomiting?

If yes, for how long?

NEW CLIENTS/PETS - Does your pet have any previous diagnoses?

If yes, please explain

Have you or your pet traveled out the area?

If yes, where?

Is your pet regularly taken for grooming?

Is your pet regularly taken for boarding?

Does your pet go to dog parks?

Is your cat kept strictly indoors, or is he/she an indoor/outdoor cat?

Indoor Only
Indoor/Outdoor

Does your pet have any lumps, bumps, or masses? If yes, please describe where on the pet's body they are located.

My signature authorizes that I will be giving VERBAL CONSENT via telephone while curbside, based on an accurate explanation of treatment plan & charges provided to me by the Veterinarian or Veterinary Technician who speaks with me during my pet's appointment

Please upload any necessary medical records

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

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