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Curbside Check-In Form

Thank you for giving East Longmeadow Animal Hospital the opportunity to care for your pet(s). During this time, we are asking all clients to fill this out prior to their pet’s appointment.

Please note: In order to schedule an appointment, please call our team or click here. Please schedule your appointment prior to completing the check-in form below.

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 *

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

List Medications your pet is currently taking

Do you need refills of any of these medications

If you need a medication refill, please list which medications

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?

File Upload

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

Comment

Because they aren’t just a pet… they’re family.

ADDRESS

572 North Main Street
East Longmeadow, MA
Click here for directions.

HOURS

Mon-Fri: 8:00am – 5:00pm
Sat: 8:00am – 12:00pm
Sun: Closed

CONTACT

Phone: 413-788-9657
Fax: 413-788-0776
Email: elahcrew@gmail.com

Have a question?

Use the form below to send us a message! A member of our team will get back to you as quickly as possible. If you need immediate assistance, please give us a call at 413-788-9657.

Name *

First

Last

Email *

Phone

How can we help you? *

Comment

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APPOINTMENT

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