Recheck info

Thank you for confirming your pet's recheck appointment with AADCI.

Please answer the questions below. Receiving this information ahead of time will enable us to prepare for your pet's upcoming appointment and make sure we have the refills you need in stock and ready for pick up.

PLEASE ANSWER THE QUESTIONS BELOW

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Name *

First

Last

Pet's Name *

Email *

What medication(s) is your pet currently receiving? Please list the medication name, dosage strength, and frequency. *

Do you need any medication refills? *

Is your pet currently receiving antigen injections? *

If your pet is receiving antigen injections, how often are you giving the injection? How much are you administering each injection? *

Do you need a refill of Vial 2 or Molds? *

What concerns/issues would you like addressed at this appointment? *

Has your pet been treated or evaluated for any non-dermatologic issues/illness since their last visit with AADCI? *

If you answered yes above, please list the name(s) of the hospitals visited so we can obtain medical records to review prior to your visit *

Submit

Recheck Appointment​Information

PLEASE ANSWER THE QUESTIONS BELOW

Recheck Appointment
Information