Crescenta Cañada Pet Hospital
Canine Check In Form
Download our app before your visit!
Who is bringing in the pet?
Phone number to use during the visit
What is the reason for the visit?
Do you need any prescriptions or flea/tick/heartworm medications refilled?
Do any of the following apply to your dog?
Stays at a boarding/kennel?
Goes to the groomer?
Lives with multiple pets in the home?
Lives with children in the home?
What flea and parasite control is your dog currently on?
When was the flea and parasite control last given?
Has your dog experienced any changes in urination or defecation?
Has your dog experienced any changes in behavior?
Is your dog on any medications, supplements or vitamins? Please list all.
What do you feed your dog? How much and how often?
Is there anything else we should know before we see you and your dog?
Should be Empty: