Hopmeadow Animal Hospital

235 Hopmeadow Street
Simsbury, CT 06089

(860)658-1931

www.hopmeadowanimalhospital.com

Hopmeadow Animal Hospital: Patient Pre-Visit Questionnaire

Now that our appointments are not as streamlined as they were before COVID-19, we ask for your patience while you are waiting outside. Curbside veterinary care is new to us all.

We ask that you remain in the parking lot while the doctor is examining your pet. The doctor will be reaching out to you by phone. To save time, please answer your phone when they call.

We are working hard to keep our patients, clients and staff as safe and healthy as possible. When interacting with our staff we ask that you have your pet outside of your vehicle and you are wearing a face covering.

When you arrive call the office we will be asking you the questions below.

 

 

 

Has your pet…

  • Been exposed to any humans that have been sick in the past 30 days?
  • Been recently adopted? Date of acquisition: ______________

Have you …

  • Been exposed to anyone that has been exposed to COVID or anyone that is sick with COVID like symptoms?
  • Traveled out of the State of CT? ______ Which state? ________
  • According to State guidelines should you be quarantining? 

 

Pet's Current diet: ___________________________   Is this a Grain Free diet? __________

Heartworm Preventative: ______________  Flea & Tick Meds: ___________

Current medications: __________________________________________

 

Recently, has your pet had any of the following signs? 

       Coughing

       Vomiting

       Diarrhea

       Sneezing

       Soft stool

       Other

       Change in appetite?

       Change in energy?

       Change in thirst?

       Change in urination?