Curbside Check-In Form

When curbside service is required, this form allows you to check in from your vehicle. Our team will confirm your arrival and stay in communication with you while your pet is being cared for inside the clinic.

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Arrival Information

Curbside Appointment Check-In

Use this form to notify our team when you have arrived for curbside service. Once submitted, a member of our staff will contact you and guide you through the next steps of your pet’s visit.

Pet's Name: *

Appointment Date/Time *

Date

Time

What is your pet's main concern today? *

Has your pet had any medication recently?

When did your pet last eat? *

The estimated cost for today's examination / procedures is:

I fully understand that this is an estimate only. West Niagara Animal Hospital makes every effort to remain within the estimate given. *

I have read and understand

I can be contacted today via text message for updates on my pet's status. Mobile number for texting updates: *

I agree to meet the costs of all treatment at the time of discharge. I understand the risks and complications of these procedures, which have been explained to me by the Veterinarian. *

I agree and understand

All accounts are payable at the time of consultation unless a prior arrangement has been made.

Owner's Name *

First

Last

Email *

Owner / Agent Signature *

Clear Signature

Today's Date *

Message

Curbside Check-In Form

Arrival Information

Curbside Appointment Check-In

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Caring Veterinary Services in Lincoln, ON

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