Email * Patient's Name * Please specify Have you booked your appointment yet? * Primary Reason for Appointment / Concern (please be as detailed as possible) * If your pet is an exotic (bird or reptile) or pocket pet species (bunny, ferret, guinea pig, rat, hamster or chinchilla etc.) Please describe it’s environment & nutrition regimen & photos of enclosure if possible List ALL medications your pet is currently taking. Please include dosage, frequency, and any flea/tick/heartworm or over the counter (including CBD) products. Do you need refills of any of these medications If you need a medication refill, please list which medications
If you do not need a refill, please put N/A.
Please list what diet / food your pet currently eats (include brand & feeding schedule) and all treats and how often given. Do you need refills on any prescription pet food? If you need a prescription pet food refill, please let us know which kind If yes, for how long? If yes, for how long? NEW CLIENTS/PETS - Does your pet have any previous diagnoses? If yes, please explain Have you or your pet traveled out the area? If yes, where? Is your pet regularly taken for grooming? Is your pet regularly taken for boarding? Does your pet go to dog parks? Is your cat kept strictly indoors, or is he/she an indoor/outdoor cat? Does your pet have any lumps, bumps, or masses? If yes, please describe where on the pet's body they are located.