Patient History (Pre-Appointment) Form

Please complete this form the day before or morning of your appointment. Be sure to complete the security questions and click the SUBMIT button at the bottom of the form when you are done.

All questions in this form (including name, contact details, and COVID-19 screening) refer to the person accompanying your pet to the appointment.

 
 
Does your pet live with anyone that has tested positive for COVID-19 in the last 10 days or has a fever, respiratory symptoms, loss of smell or taste, conjunctivitis or other contagious illness symptoms?*

If yes, please arrange for someone outside your home to bring your pet in on your behalf, and call us right away if that is not possible, so that we can make a plan together. This is essential so that we can protect our team members and ensure that we can stay open to help pets in need.
 
Please also bring a picture of your pet's food package(s) to your appointment.
Please include the dose you are currently giving them, and how often they get each medication or supplement.
If so, please provide details (when it started, frequency, appearance.
Please include any time in the backyard or on the porch or balcony.
Have we prescribed or suggested your pet take calming medication before their visits with us?*
Does your pet have health insurance?*
If no, would you like a free pet insurance trial?
Pet insurance can help ensure that you can treat your pet if they have an accident or develop a health issue that requires expensive medical care. Most pet insurance companies offer free trials on the same day as a vet exam. If you are interested, please ask us about insurance during your appointment. (Free trial options are available for pets 8 weeks to 14 years old - older pets are still eligible for insurance, but not for free trials).
If you have Trupanion, OVMA or PetSecure insurance, we can submit your claims electronically for you - just ask! For other insurance companies, please ask us about signing a master insurance claim form so that we can help you submit your claims.
Security Question*
 
 

Practice information

Bloorcourt Veterinary Clinic

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  • Mon
    8:00am – 8:00pm
  • Tue
    8:00am – 8:00pm
  • Wed
    8:00am – 1:30pm & 3:00pm – 8:00pm
  • Thu
    8:00am – 8:00pm
  • Fri
    8:00am – 8:00pm
  • Sat
    9:00am – 3:00pm
  • Sun
    Closed (Sundays & Holidays)

After-Hours Emergencies

Please call:

416-784-4444
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Find us here:

1074 Bloor Street West Toronto, Ontario, M6H 1M6
get directions with Google Maps
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For after-hours emergencies, please call:

416-784-4444