Appointment Questionnaire

Appointment Questionnaire


A change in appetite?

Weight gain or weight loss?

Excessive scratiching or itching?

Lumps or bumps?

Dental Problems? (i.e bad breath, tartar, blood in mouth)?

Stiffness on rising, less willing to jump into the car?

Decreased energy levels?

Coughing, sneezing or difficulty breathing?


Change in bowel movements (consistency or frequency)?

Change in drinking/urination (circle-less or more)?

Eye problems (vision changes, discharge)?

Ear problems (head shaing, scratching, odor, discharge)?

Flea or ticks?

Do you board your pet, take to day care or grooming?

For Dogs:

Travel out of State?

Monthly heartworm preventative?

For Cats:

Does your cat go outside or come into contact with other cats?

Please list all the medications and supplements your pet currently receives.

What's Next

  • 1

    Call us or schedule an
    appointment online.

  • 2

    Meet with a doctor for
    an initial exam.

  • 3

    Put a plan together for
    your pet.