Skip to main content
Home
Contact
Call Us:519-396-2071
Our Location
What to Expect
Emergencies
What We Do
Fear Free
Individualized Wellness
Surgery
Laser Therapy and Physical Rehabilitation
Who We Are
Our Team
Our Story
Resources
Book an Appointment
Prescription Refill and Food Order Request Form
How Sick is My Pet
Pet Health Library
How To Videos
PetPage App
Swiftails Exotic Vet Telemedicine
Traveling to The US
Webstore
search
twitter
facebook
Hit enter to search or ESC to close
Request Appointment
Request Refills
Call Us:519-396-2071
Drop off Exam Questionnaire
Please describe in detail the problem your pet is experiencing that has brought you to make an appointment at the clinic.
*
How long has this problem been going on for?
*
Please describe the progression of the problem since it started.
*
Is there anything that makes the problem worse or better?
*
Is your pet experiencing any problems other than the one indicated above?
*
Yes
No
Please list and describe the other problems.
*
How long have the other problems been going on for?
*
Please describe the progression of the other problems since they started.
*
Please list any treatments, medications, or supplements that you provide for your pet, including the dosage, frequency and when started.
*
Please describe your pet's appetite, including when they last ate and what they - are currently eating.
*
Has this changed in the last year?
*
Has there been any vomiting in the last month? If yes, please describe.
*
Please describe your pet's bowel movements, any changes over the last year, and when the last stool was produced.
*
Please describe your pet's thirst and if there have been any changes in the last year.
*
Please describe your pet's urination frequency and when the last urination occurred.
*
Has the volume of urine or frequency of production of urine changed in the last year?
*
Please describe your pet's energy levels and whether they have changed in the last year?
*
Has your pet's weight changed in the last year? Please describe the changes.
*
Have there been any changes in your pet's skin or haircoat, including new lumps, itchiness, hairloss, loss of shine, reduced grooming? Please describe the changes you see.
*
Is your pet coughing or sneezing? If yes, please indicate when this started, when it occurs in the day, if it is changing over time.
*
Is there anything else you feel we should know prior to your pet coming into the clinic?
Is there anything else you'd like the veterinarian to address during the appointment if there is sufficient time?
Δ
Home
Contact
Call Us:519-396-2071
Our Location
What to Expect
Emergencies
What We Do
Fear Free
Individualized Wellness
Surgery
Laser Therapy and Physical Rehabilitation
Who We Are
Our Team
Our Story
Resources
Book an Appointment
Prescription Refill and Food Order Request Form
How Sick is My Pet
Pet Health Library
How To Videos
PetPage App
Swiftails Exotic Vet Telemedicine
Traveling to The US
Webstore
twitter
facebook