Canine- New Puppy/ Dog - First Visit
Phone Number for call or text during pet's visit
Where did you get your pet?
How long have you had pet?
Previous Preventive Care (Vaccines, Deworming) - What and where?
As much as you know or upload records below if you have them
Upload previous medical records here (or you can text us a picture of them if you are unable to do this) Please send them prior to the visit so we can be better prepared, if possible.
Heartworm or Flea & Tick Preventive- What Product, Date last applied?
Are you planning to have your pet spayed/neutered?
no will breed
not planning to and not intending to breed
Any Behavioral or Medical Concerns?
Anything else you would like us to know?
How will you be paying today? (Cash, check, credit/debit, or care credit)
In last 2 weeks, has pet had any potential exposure to person with symptoms of or that has been diagnosed with COVID-19?
Should be Empty: