BFVC Check-in Sheet
Help us speed up check-in and fill out this form!
First & Last Name
Please select all that apply
I have been experiencing cold/flu symptoms
I have been exposed to COVID-19 in the last 14 days
None of the above
Phone number I can be reached at for today’s visit
Has your pet been eating and drinking like normal? (If no, please explain and note when you noticed the change)
Has your pet experienced any diarrhea or vomiting? (If no, please explain and note when you noticed the change)
While my pet is here I would like the following done if possible
All vaccines that are due
Only select vaccines, regardless of what is due
Bloodwork that is due (ex, heartworm test, thyroid panel, glucose check, etc.)
While my pet is here today I approve the following treatments and/or diagnostic tools that may be recommended by the veterinarian.
Urinalysis & Cytology
Skin Cytology & Skin Scraping
Anal Gland Expression
Nothing, must discuss 1st (this may lengthen appointment time)
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This form was created inside of Burnt Fork Veterinary Clinic.