COVID-19 Car Form

Welcome to Guardian Animal Medical Center!

Please complete the form below once you arrive for your scheduled appointment. If you need immediate assistance, please call or text us at 606-928-6566.

Name *

First

Last

(for receipt)

Phone number for today's visit *

Is your phone an

iPhone
Android

Allow a Facetime from 606-928-6566

Download Zoom and look for an email invite.

In order to allow us to prepare to see your pet:

Exposed to COVID-19? *

Are you or someone in your car exposed to COVID-19? *

Quarantined? *

Are you or someone in your car exposed to COVID-19? *

Do you need any refills? *

Product #1 Requested (Please list medication name, dosage and strength, and quantity needed)

Product #2 Requested (Please list medication name, dosage and strength, and quantity needed)

Product #3 Requested (Please list medication name, dosage and strength, and quantity needed)

Pet Food

Car Breed *

Please select your payment option *

Credit Card (MC/Visa)
Cash

Name

We’ll be there when you need us.

Our Location

918 Bellefonte Road
Flatwoods, KY 41139
Click here for directions.

Our Hours

Mon, Tues, Fri: 8:00AM – 6:00 PM
Wed: 8:00AM – 2:00PM
Thur: 8:00AM – 7:00PM
Sat: 8:00AM – 12:00PM
We will be closed on some Saturdays. Please contact us to confirm our hours.

Contact Information

Call/Text: 606-928-6566
E: GuardianAppt@gmail.com
Tri State Animal ER: 304-453-5700

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