Canine and Feline Wellness Checklist

Dear Friends,

In order to respect physical distancing and to help minimize wait times, we are asking our clients to kindly respond to the following questions and email your responses 24-48 hours before you arrive for your appointment.

Appointment times are booked for 30 minutes. If you have a concern about your pet or a new health issue arises between booking and your appointment, please notify us ASAP as we may want to adjust the appointment to allow for more time and/or change the appointment sooner.

When you arrive, please call the clinic to let us know you are here, confirm your contact information and let us the know the make and color of your vehicle.

Please let us know ahead of time if you have any questions.

* Indicates required field

Date *

Name *

First

Last

Patient/Pet *

Confirm Address *

Line 1

Line 2

City

State

Zip Code

Country

Contact Phone Number For Appointment *

Email *

Reason for your pet's visit? *

If your pet is with us for vaccines, have they had any of the following after vaccines? (vomiting, diarrhea, lethargy, pain at vaccine site) *

Is your pet urinating normal amounts? or Increased *

Do you have any concerns or are there any changes in your pet's overall health? Has their energy level changed? If so, how? (increased/decreased) *

Are there any changes in their eating or drinking habits? If so, how? (increased/decreased) *

Has your pet had any episodes of vomiting, diarrhea, coughing or sneezing?And frequency? *

Is your pet experiencing any ear, eye, skin or other dermatological issues (growths or masses) we should know about? *

Does your pet strain to urinate or defecate? *

What medications (including supplements) is your pet on? (or none) *

Do you have any concerns about their weight? *

Please specify the brand of your pet's diet and whether it is a dry food, canned or both. *

Your Pet's Lifestyle

Does your dog travel (cottage). If so, where? Does your cat travel or go outside? (leash, deck, porch, backyard, free roam) *

Wellness Bloodwork

It's Flea and Tick Season!

Bravecto can Ticks start emerging at 4 degrees and above. We recommend starting Bravecto or Credelio in March because
temperatures are starting to become warmer increasing your pet's chances of coming in contact with them. Currently, Bravecto is offering a rebate of up to $35.00 on 3-4 doses of Bravecto.

Bravecto can be used on pets six months and older that are not still in their growth phase.

Yes, I would like to start my pet on prevention. *

Bravecto Topical - 12 week protection Bravecto Chewable - 12 week protection Credelio - monthly protection Bravecto Cats Topical - 8 week protection for ticks

How many Doses? *

1 dose 2 doses 3 doses 4 doses

We really appreciate you taking the time to submit this questionnaire ahead of time as it allows us more time to focus on your pet.

Submit