Request an Appointment

Our team will reach out to confirm your appointment.

This form is used to request an appointment. A member of our team will contact you shortly to review availability and finalize the details of your visit.

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New Client Information

Our team will reach out to welcome you.

Welcome to AAVH. Please complete the form below. Once submitted, a member of our team will contact you to follow up and assist with next steps.

Client Information

Name *

Spouse or Co-Owner of Pet

Phone Number *

Secondary Phone Number

Email Address

Occupation / Employer *

Work Phone Number

Pet Information

Pet's Name

Species

Breed

Age / Date of Birth

Sex / Spayed or Neutered

How Did You Hear About Us?

How did you hear about Anne Arundel Veterinary Hospital?

Next Steps

Please select all that apply

Next Steps: contact me to schedule an appointmentI would like the hospital team to contact me to schedule an appointment.

Next Steps: information about wellness packages, dental care, or senior screeningI would like information about wellness packages, dental care, or senior screening.

Next Steps: will provide or request transfer of prior medical recordsI will provide or request transfer of my pet's prior medical records if available.

Printed Name (Signature) *

Date *

Submits to info@annearundelvet.com

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Wellness & Vaccine Package Selection

Adult and Senior Pet Wellness Packages

Use this form to document package selection and client acknowledgment. Packages are valid for one pet for 1 year from date of purchase and are non-transferable.

Canine Vaccine Information & Consent

Please complete one form for each dog.

This form supports vaccine discussions and consent. Final recommendations are made by the veterinarian based on the dog's age, medical status, lifestyle, vaccine history, and prior records.

Feline Vaccine Information & Consent

Please complete one form for each cat.

This form supports vaccine discussions and consent. Final recommendations are made by the veterinarian based on the cat's age, medical status, lifestyle, vaccine history, indoor/outdoor risk, and prior records.

Medical History — Sick Patient

May be requested by our team when additional history is needed.

Please complete this form if requested by our team or if your pet has medical concerns, medication changes, diet changes, or new symptoms.

Pet's Name *

Owner / Client Full Name *

Preferred Pronouns

Phone Number *

Email Address

Current Concerns

Please describe your pet's current concerns or symptoms *

Please list any medications you need refilled at your appointment. If none, write NONE. *

Please list all known allergies to medications, vaccines, or food. If none, write NONE. *

Please list the type, brand, and amount of food your pet receives. Include treats. *

Diet details

Diet: raw dietRaw diet

Diet: grain-free dietGrain-free diet

Additional information that may help the doctor

Wellness & Travel

Wellness plan interest

Wellness plan: yes, would like informationYes, I would like information about wellness packages

Wellness plan: noNo

Wellness plan: already on a wellness planMy pet is already on a wellness plan

Travel plans

Travel: within the United StatesYes, travel within the United States

Travel: internationalYes, international travel

Travel: noNo

Printed Name (Signature) *

Date *

Submits to info@annearundelvet.com

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Dental Cleaning Promotion Consent

One form per pet scheduled for the dental cleaning promotion or free dental exam.

This form documents consent for routine dental cleaning under anesthesia and acknowledgement of what is and is not included in the promotional dental cleaning price.

Pet's Name *

Owner / Client Full Name *

Phone Number *

Email Address

Species (Dog or Cat)

Date *

Included in the Promotional Price

Please acknowledge

Included: anesthesia, cleaning, scaling, polishing, oral evaluationI understand the promotional dental cleaning includes anesthesia, professional dental cleaning, scaling above and below the gumline, polishing, and oral health evaluation during the procedure.

Services Not Included

Please acknowledge — billed separately if recommended or needed

Not included: pain medicationI understand pain medication is not included.

Not included: antibioticsI understand antibiotics are not included.

Not included: dental radiographs / X-raysI understand dental radiographs / dental X-rays are not included.

Not included: tooth extractionsI understand tooth extractions are not included.

Not included: additional treatments or proceduresI understand additional treatments or procedures are not included.

Not included: advanced dental surgeryI understand advanced dental surgery is not included.

Printed Name (Signature) *

Signature Date *

Submits to info@annearundelvet.com

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Client Forms

Quick Form Guide

Request an Appointment

New Client Information

Client Information

Pet Information

How Did You Hear About Us?

Next Steps

Wellness & Vaccine Package Selection

Package Selection

Additional Consent Requirement

Important Package Information

Canine Vaccine Information & Consent

Canine Vaccines to Discuss

Health Screening Questions

Feline Vaccine Information & Consent

Feline Vaccines & Tests to Discuss

Lifestyle and Risk Questions

Medical History — Sick Patient

Current Concerns

Wellness & Travel

Dental Cleaning Promotion Consent

Included in the Promotional Price

Services Not Included