What is the main reason for your pet's visit today? Please tell us more. Has your pet experienced any change in weight? Describe anything you have noticed that may be contributing to the weight change, including changes in diet/exercise. Please expand on what you indicated above:
(Location of new lumps/bumps, changes you've noticed at home or any other concerns.)
My pet's appetite is: When did you notice this? My pet's thirst level is: When did you notice this? My pet's activity level is: When did you notice this? My pet's urination is: When did you notice this? My pet eats (pick all that apply): If other, please specify: Brand of Pet Food If prescription diet, what formula? How often is your pet fed? How much is your pet fed? In addition to pet food, what treats or other food does your pet receive? Include any human food, veterinary dental products, bones, rawhides, treats, etc). Has your pet's diet changed in the last 6 months? Is it possible for your pet to have: Please tell us more: Please list any medications, supplements, or topical treatments your pet has received in the past month and when they were last given: Are there other pet's in the home? Is your pet current on vaccinations? My pet's vaccines were administered last by: If other, please specify where: Does your pet have a microchip? Has your pet bitten anyone in the last 10 days? Does your pet have any known health concerns and/or chronic diseases or conditions? Is there anything else we should know about your pet?
If yes, please tell us more. If no, please note N/A.
Is there anything else you would like to discuss today?