Puppy/Kitten Examination Questionnaire

Puppy/Kitten Examination Questionnaire

Please answer all questions, prior to the appointment date, to the best of your ability. If you are unsure or have questions, please mark “Unsure” or “Unknown”.

Is your pet microchipped?

Please provide a birthdate or approximate age.

It is important that you submit, or bring along with, a copy of your pets records to your appointment. Regardless of the deworming status, we recommend bringing a fresh fecal sample to your appointment to screen for intestinal parasites.

It is important that you submit or bring a copy of your pet’s records you to your appointment.
Has your pet had any previous vaccine reaction(s)? (i.e. vomiting, diarrhea, lethargy, soreness, swelling, or hives)

Do you plan on:

Will your pet be primarily:

Please check any extracurricular activities that your pet will participate in:

Below is a list of common medical concerns reported in pets. Please check each symptom, that applies to your pet, below.

Are you familiar with pet insurance?

Would you like more information regarding pet insurance?

If your pet has any previous medical records, please email them to [email protected].