Cell Phone (we will need to reach you to discuss the exam)
Which parking spot number are you in?
Reason for Visit
Is your pet eating, drinking, urinating and defecating normally? If not, please explain:
Do we have permission to update vaccinations that are due or past due? These may include:
Do we have permission to update wellness testing that may be due or past due? These may include:
Intestinal parasite screening
Heartworm and tick disease testing
Are there any issues you would like to address with the doctor today?
Is your pet current on flea/tick and heartworm medication?
If no, when was the last dose given?
Please give my dog a Proheart Injection. (Proheart is a heartworm prevention injection that lasts for 12 months)
Do you need refills?
6 months Flea/Tick
12 months Flea/Tick
6 months Heartworm
12 months Heartworm
For our kitty friends- does your cat go outside?
Sometimes goes in the yard
Should be Empty: