Urine & Fecal Drop-Off Questionnaire

Urine & Fecal Drop-Off Questionnaire

Vomiting/Diarrhea & Urinary Issues
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Pet's Name*
Is your pet still eating and drinking?*

YesNo
Is your pet acting sick or lethargic?*

YesNo
Is your pet having diarrhea?*

YesNo
If sick, how long has your pet been experiencing this issue?*
What brand & type of food is your pet eating? How long? Is this a new bag?*
What does it look like? Any blood or mucous?*
Is your pet vomiting?*

YesNo
If yes, for how long?*
What does it look like? Food or bile?*
Has your pet got into the garbage recently? Are they likely to chew on toys or small items?*
Is your pet having urinary issues?*

YesNo
If yes, please explain what you are noticing (ex. freq. urination, drinking a lot, in & out of the litterbox etc.):*
Are you noticing blood in the urine?*

YesNo
What time did you collect your sample?*
How did you get your sample? (Ground, counter, caught, etc.)*
Has your pet been to a kennel or under any new stress? When?*
Is your pet free roaming or off leash?*
If this is a drop off sample, do you prefer a call or text with results?*

CallText
Is there anything else you would like us to know?*
You will be asked to pay for your pet's testing when you drop the sample off. The amount will be between $30-$54 depending on the sample type. If additional diagnostics or medications are needed there will be additional charges. Thank you!
Should be Empty: