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410 -751- 0091

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At Antrim Veterinary Hospital, the doctors and staff have prided themselves on providing complete, high-quality care for dogs and cats in Taneytown since 1995.

Antrim Veterinary Hospital is dedicated to keeping pets happy, healthy and safe.

For scheduled appointments:

If your appointment has already been scheduled, please complete the following questionnaire at least 24 hours prior to your appointment. Thank you!

Pre Visit Questionnaire

First & Last Name

Pet's Name

Phone

Reason for Visit

Vaccines

Allergies (licking, scratching)

Ear infection

GI upset (vomiting, diarrhea)

Other

If other, please explain:

Current Diet

Has your pet had any diarrhea or vomiting?

Has your pet been coughing or sneezing?

Please list all current medications

Current heartworm prevention

Nexgard PLUS (heartworms, fleas and ticks)

Heartgard (heartworms only)

Other

None

If other, please provide name

Current flea and tick prevention

Nexgard PLUS (fleas, ticks and heartworms)

Nexgard (fleas, ticks only)

Frontline

Other

None

If other, please provide name

If there is anything needed other than what your appointment has been scheduled for, please let us know. We may reach out to you if your appointment time needs to be adjusted based on these requests.

Thanks for submitting! We look forward to seeing you soon!

520 E. Baltimore St. STE. 200 Taneytown, MD 21787 410-751-0091

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