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Leawood-plaza - Canine Health Questionnaire
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    Canine Health Questionnaire

    One of the challenging aspects of veterinary medicine is evaluating the health of patients who cannot talk to us. Remembering that pets age at a rate up to seven times faster than our own, makes this challenge even more important. As pet health care professionals, we depend greatly on the information provided to us by pet owners and family members. We would like to ask for your assistance.

    In an effort to provide your pet with the best health care, we ask that you take just a few moments to answer the following questions. Making health care decisions with respect to age and lifestyle allows us to tailor our treatment and advice more effectively for every patient.

    We thank you (and your pet thanks you) for your assistance toward this effort!

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  • 2
    • Yes
    • No
    • Yes
    • No
    • Yes
    • No
    • Yes
    • No
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  • 3
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  • 4
    • Yes
    • No
    • Yes
    • No
    • Yes
    • No
    • Yes
    • No
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  • 5
    • Yes
    • No
    • Yes
    • No
    • Yes
    • No
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  • 6
    • Yes
    • No
    • Yes
    • No
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  • 7
    • Yes
    • No
    • Yes
    • No
    • Yes
    • No
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  • 8
    • Pleasant - Not bad
    • Unpleasant - Really Bad (needs mouthwash!)
    • Not a big water drinker
    • Normal
    • Occasionally drinks a lot
    • Always drinks a lot
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  • 9
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  • 10
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  • 11
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  • 12
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  • 13
    *Please note that the last available appointment on Saturday's is 11:45 AM
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