AHAH Drop Off Form
Date Format: MM slash DD slash YYYY
Please be aware that under HIPAA laws, we are only allowed to share healthcare information about the pet with the owners, co-owners, and authorized names we have on file. To update this list please contact us by phone, email at firstname.lastname@example.org, or through the AHAHVet app.
Click CTRL on your keyboard and left click to select multiple
Accepted file types: jpg, png, .
Here you may upload up to three photos indicating where the problem is. If you decide to upload, please submit at least one photo showing your whole pet's body and you pointing to the site it is having trouble with. Then you may submit one up close of where the problem is.
Type N/A if no medications
If you have indicated skin and/or gastrointestinal issues, please fill out the Dermatology and/or Gastrointestinal History Forms as well.
Thank for filling out the drop off form! Our staff will contact you at the number above with a treatment plan and an estimate of charges after we have examined your pet.