woman sitting on a bed with a dog

Online Forms

New Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before our visit.

Online Forms

New Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before our visit.

New Client Form

This form is for new clients seeking annual physical examination or care for a minor illness.

Your pet must be up to date on his or her rabies vaccination. If you are unable to provide proof of a current/valid rabies vaccination we can administer a rabies vaccine and provide a Rabies Certificate.

ex: Hospitalized in 2010 for pancreatitis at XYZ Emergency Hospital; Diagnosed with Feline Asthma in 2020 at XYZ Animal Clinic
If your pet has had a documented vaccine reaction in the past we will not be able to vaccinate them. Instead, we will refer you to a full service veterinary clinic/hospital.
Example: Medication -> Apoquel 16 mg once daily since 2017. Example: Prescription Diet -> 2 cups of Royal Canine Satiety Support twice daily.
Click or drag files to this area to upload. You can upload up to 5 files.
Updated lab work may be required before refilling certain medications. If you can't take photos please include the names of the medications in the box above this one.
If you schedule an annual exam, Dr. Cover will assess a maximum of two additional health concerns before the appointment is converted to an urgent illness exam. Please review our website for current pricing of an urgent illness exam as this is different from the price for an annual exam. *If you have refill request you may list them here*
Basic Veterinary Services include, but are not limited to, blood draw, injections, etc.
If you are not able to safely handle your pet then we may employ additional handling methods (i.e. muzzle, additional veterinary assistance etc). Please review the policy agreement for more information.
Click or drag files to this area to upload. You can upload up to 5 files.
If you are unable to upload them during this session we ask that you email them to info@aysmobilevet.com at least 48 hours prior to your appointment. In order for your appointment to be confirmed please email your medical records.