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Call Us:519-396-2071
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Fear Free
Pain Management
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Gentle Geriatrics
Oral Care
Diagnostic Imaging
Surgery
Chiropractic, Trigger Point, Laser Therapy and Physical Rehabilitation
Nutritional Counselling
Behavioral Counselling
Who We Are
Our Team
Our Story
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Prescription Refill and Food Order Request Form
How Sick is My Pet
Pet Health Library
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Pet Food Recalls
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Call Us:519-396-2071
Pre Exam Questionnaire
We also ask that you complete the following questionnaire and return it to us at least 24 hours before your appointment. As our COVID-19 protocols mean communication is more difficult, we would like to continue to provide excellent care for your pet and prevent details from falling through the cracks.
First Name:
*
Last Name:
*
Pet's Name
*
Please list everything that goes into your pet’s mouth during a 24 hour period:
What specific diet is your pet eating? How much does your pet eat in a day?
How would you describe your pet’s appetite?
How is it compared to last year?
What does your pet chew on?
Please describe your pet’s breath:
How would you describe your pet's water consumption?
How is it compared to last year?
Please describe your pet’s bathroom habits for both urine and bowel movements:
How has this changed over the last year?
How often do you need to clean up messes (any kind of mess) after your pet? Please provide details.
Does your pet sleep through the night?
Does your pet sleep through the day?
How has this changed over the last year?
Please describe your pet’s ability to exercise, play, be active, get up and down:
How does your pet move?
Has any of this changed in the last two years?
FOR CATS: Does your pet go outside or is your pet strictly indoors?
How would you describe your pet’s weight now?
Has it changed in the last year and how?
Does your pet make any noise when breathing, cough, snore, or sneeze? Please describe.
Has your pet’s skin changed in the last year?
What have you noticed about your pet’s smell, coat thickness, flakiness or cleanliness?
What do you do to maintain your pet’s hair coat and ears?
Is your pet currently on any medication or supplements (parasite prevention included)? If so, please provide the name and dosing information for all products. (eg. 1 x 100 mg gabapentin twice daily)
Do you buy anything on line that you give to or put on your pet?
Has your pet ever had a reaction to a vaccination or a medication? If a medication, please list the medication and the reaction.
Please describe your pet’s behaviour in the house:
Is there any behavior you wish your pet did not do or that worries you?
Do you think your pet is happy?
Do you think your pet is healthy?
What does your pet mean to you?
What is your pet's nickname?
Is there anything you would like to discuss with the veterinarian specifically? If there is an issue, please try to get a video of the problem, or send in photos to info@kinvet.com.
If you are not currently a client with us, what is the name of your previous veterinary clinic?
Does your pet have pet insurance protection? If so, what company is it?
Thank you so much for taking the time to fill out this questionnaire. We look forward to seeing you soon!
Home
Contact
Call Us:519-396-2071
Our Location
What to Expect
What We Do
Fear Free
Pain Management
Individualized Wellness
Gentle Geriatrics
Oral Care
Diagnostic Imaging
Surgery
Chiropractic, Trigger Point, Laser Therapy and Physical Rehabilitation
Nutritional Counselling
Behavioral Counselling
Who We Are
Our Team
Our Story
Resources
Prescription Refill and Food Order Request Form
How Sick is My Pet
Pet Health Library
How-To Videos
PetPage App
Pet Food Recalls
Product Recalls
Pre-Exam Questionnaire
Webstore
