Name: Hope Animal Hospital
Address: 1042 Sam Lattimore Rd., Shelby, NC, 28152, US
Telephone: (704) 481-8005
Price range: $$

Pre-Appointment Information Form: Curb-side Care

During the COVID-19 Pandemic, our practice is using “curbside care” to limit physical contact and adhere to social distancing recommendations. These new procedures help to limit exposure, not only to pet owners, but also to our veterinary team.

Please call the office to schedule an appointment for your pet.

In order for your veterinary healthcare team to provide comprehensive care for your pet, please fill in this form and return via email prior to your visit.

Date:*
dd/mm/yyyy
Owner's Name
Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Day-Time Phone*
Evening Phone
Mobile Phone
Email*
Pet Information
Pet's Name*
Species*
if other please specify
Breed (if known)*
Sex*
Color*
Date of Birth or Age (if known)*
Pet Health - Reason for Visit
Describe your concern*
How long has this been going on?*
Days/Weeks/Months
What are you currently feeding the pet?*
food/treats
How is their appetite?*
poor/good/excellent
Are you currently giving any medications or supplements?*
- yes
- no
Please specify*
name/dose/last given
Any coughing or sneezing?*
- yes
- no
Please describe*
Any vomiting or diarrhea?*
- yes
- no
Please describe*
Have they gotten into anything? Eaten anything unusual?*
- yes
- no
Please describe*
Is your pet indoors only? (Cats)
Any environmental changes?*
Describe their behavior*
lethargic/normal/hyperactive
Any changes to thirst?*
increased/normal/decreased
Any changes to urination?*
increased/normal/decreased
How are their bowel movements?*
normal/abnormal
When was their last bowel movement*

We'd Love To Hear From You!

Exceptional Pet Care
In Cleveland County

Proud to be serving our small community and surrounding areas since 2009. Originally founded by Dr. Deanna Moseley Lawrence, we continue to offer excellent services to our patients and clients.

Contact Us

1042 Sam Lattimore Rd.
Shelby, NC 28152

Call: (704) 481-8005
Fax: (704) 481-8006

Email Us Get Directions

Hours

Monday: 8:00am – 5:30pm
Tuesday: 8:00am – 5:30pm
Wednesday: 8:00am – 5:30pm
Thursday: 8:00am – 5:30pm
Friday: 8:00am – 5:30pm
Saturday & Sunday: Closed

Online Client Forms

Pre-Appointment Information Form: Curb-side Care

Owner's Name

Pet Information

Pet Health - Reason for Visit

We'd Love To Hear From You!

Exceptional Pet Care In Cleveland County

Contact Us

Hours

Exceptional Pet Care
In Cleveland County