Hello, and welcome to Ann Arbor Animal Hospital!
If you’re a new client, please fill out the form below and click/tap “Submit” at the bottom when finished.
Please either bring your pet’s records to your visit, attach them in the spaces provided at the bottom of the form below, or email them to us at clientinfo@annarboranimalhospital.com
Also, please call us the day before your appointment to ensure that we have all of the information we need to make your appointment go as smoothly as possible. Thank you, and we’re looking forward to caring for your furry friend!
COVID-19 Screening
- I am not currently diagnosed with COVID-19
- To the best of my knowledge, I have not (within the last 5 days) been in close contact with anyone diagnosed with COVID-19 (where ‘close contact’ is being within 6 feet for a cumulative 15 minutes or longer [within a given 24 hour period] OR providing care at home to someone who is sick with COVID-19 OR hugging/kissing an infected person OR sharing eating/drinking utensils with an infected person OR infected person sneezed, coughed, or otherwise got respiratory droplets on you). Note that this ‘close contact’ period begins 2 days before symptoms developed (for exposure to symptomatic individuals) or 2 days before the COVID-19-positive specimen was taken (for exposure to asymptomatic individuals).
- In the last 5 days, I have developed no more than one of these principal symptoms of COVID-19 (not counting symptoms due to a known non-COVID medical/physical condition): abdominal pain, chills, congestion or runny nose, diarrhea, fatigue (not due to another known cause), headache, muscle aches, nausea or vomiting, sore throat.
- In the last 5 days, I have not developed any of the following principal symptoms of COVID-19 (not including symptoms due to a known, non-COVID medical or physical condition): fever(≥100.4 ºF), cough (excluding chronic cough due to a known medical reason other than COVID-19), shortness of breath or difficulty breathing, loss of taste or smell.