Pre-Appointment Questionnaire

What is your pet currently eating and how much? When do you feed them? Please include all treats and snacks that they get from the moment they wake up and when they go to bed:

Have you noticed any coughing? Any sneezing? Any vomiting? Any diarrhea? If you have answered yes to any of the above questions, please provide as many details as you can. :

If your appointment is for a cat; Is your cat using the litterbox regularly?:

Yes No

If your appointment is for a cat; To your knowledge has your cat been viral tested? (This tests for Feline Leukemia and Feline FIV).:

Yes No

If your appointment is for a dog; Does your dog attend doggie daycare, play at the dog park or spend time boarding at a kennels?:

My dog attends a daycare
My dog plays at the dog park
My dog spends/ has spent time at boarding kennels

Have you noticed any limping or changes in their mobility?:

Yes
No

Has your pet had a history of vaccine reactions?:

Has your pet had a history of drug reactions or allergies? :

Does your pet do any traveling?:

Do you have pet insurance? If yes, who is your provider?:

I understand that I must have my pet on a securely tightened collar/harness and leash (not extendable leashes, if possible please) or in a secure carrier.:

I will inform the staff if my pet has special needs. It is helpful for us to know if your pet is aggressive with other pets or humans. If your pet is fearful or anxious, we may be able to provide some anxiety medications in advance for you to give 2-3 hours before the appointment.:

Pre-Appointment Questionnaire

Which practice would you like to register with?

Please answer the following questions to the best of your ability. We want to be able to provide the best care possible for your pet and the answers to these questions are an important part of your pet's consultation.

Pre-Appointment Questionnaire

Which practice would you like to register with?

Please answer the following questions to the best of your ability. We want to be able to provide the best care possible for your pet and the answers to these questions are an important part of your pet's consultation.

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