Curbside Check-In Form | Fairview Animal Hospital

(865) 379-8833 clientcare@fairviewvethospital.com

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Curbside Check-in Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Curbside Questions

I am in this vehicle: *

(Please list the model and color.)

Best phone number for today's appointment: *

(The veterinarian and technician will use this number to communicate with you through the appointment.)

Patient's Name *

Patient's Species *

Canine
Feline
Other

If 'Other', please specify: *

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

Please list the medications your pet is currently taking:

Do you need refills of any of these medications?

Yes
No

If you need a medication refill, please list which medications:

Do you need refills on any prescription pet food?

Yes
No

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?

Yes
No

If yes, for how long?

Is the patient sneezing?

Yes
No

If yes, for how long?

Is the patient vomiting?

Yes
No

If yes, for how long?

Please upload any relevant records or photos below:

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

Email

We’re excited to see you.

We proudly serve the pets of Maryville, TN, and the surrounding communities. We look forward to seeing you and your pet soon. Easily book an appointment for your pet below.

Book Appointment

Have a question?

If you would like to get in contact with us by email for general questions or to request information on our services, please use the form below. We will attempt to respond to every email in a timely manner.

Address

2648 US Hwy 411 South Maryville,
TN 37801

Contact

P: 865-379-8833
E: clientcare@fairviewvethospital.com

Hours

Monday – Friday: 7:30 AM – 5:30 PM
Saturday: 8:00 AM – 1:00 PM
Sunday: Closed
Drop-offs begin at 7:40 AM – 9:00 AM

Name *

First

Last

Email *

Phone

How can we help you? *

Phone

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