North Paws Check-in Form

North Paws Check-in Form

Take a moment and tell us more about your pet.
Is this an URGENT or Non-urgent appointment?*

URGENTNon-urgent
You selected URGENT appointment.

Cost
- $150 for non-Care Plan members
- $57 for Care Plan members
  - For more information about our Pet Care Plans, click here: Pet Care Plans
  - For interest free payment options, apply here: CareCredit
For new clients, urgent care appointments do NOT establish care with our general practice at North Paws. We will send records to your primary care veterinarian after your appointment within the next 1-2 business days. If you do not have a primary care veterinarian and would like to establish care with our clinic, please call our general practice line.

URGENT Care hours: Monday-Friday: 10am-6pm

If your urgent care case is outside our hours of operation, use the link at the bottom of this section to find an emergency veterinarian near you.

URGENT Care or Emergency?

We are equipped to handle URGENT CARE concerns, not emergencies.

If your pet is experiencing any of the following symptoms, please use one of the phone numbers listed below to call a pet emergency center near you.

Examples of URGENT care cases:
- Vomiting
- Diarrhea
- Straining to have a bowel movement
- Straining to urinate or dribbling urine; urinating outside the litterbox
- Change in urine color, frequency, or amount
- Eye swelling, discharge, or redness
- Ear pain, discharge, odor, scratching, or shaking head
- Nasal discharge
- Mouth discharge or bad breath
- Coughing or sneezing
- Change in amount of food or water intake
- Change in behavior such as lethargy, anxiety, restlessness
- Parasites such as fleas, ticks, or worms
- Minor bite wounds or lacerations
- Facial swelling and/or hives
- Skin rashes and abrasions
- Itching, scratching, chewing at skin or paws
- Limping or soreness
- Broken toenails
- Possible toxin exposure
Examples of Emergencies
- Trauma and blood loss (e.g. hit by car, gunshot wounds)
- Head or eye injuries
- Irregular breathing, shortness of breath, prolonged or heavy panting
- Severe or sudden onset of pain
- Weakness or paralysis
- Broken bones
- Large open wounds
- Possibility of having eaten a foreign body (e.g. toy, sock, etc.)
- Hyper- or hypothermia (heat stroke or frostbite)
- High fever
- Serious burns
- Seizures or other neurologic signs
- Dystocia (difficulty giving birth)
For emergencies, please refer to the following facliities:

Allied Emergency Veterinary Service

MPLS (open 24/7)

(952) 521-3030 | 5754 Nicollet Ave | Minneapolis, MN 55419

Brooklyn Park (M-F 3pm-12am, Sat/Sun 12pm-12am)

(763) 463-9800 | 301 93rd Ave N | Brooklyn Park, MN 55445

Anoka (M-F 6pm-7am, Sat/Sun 24hrs)

(763) 923-1200 | 100 W Main St | Anoka, MN 55303

Blue Pearl Pet Hospital - Arden Hills
763-754-5000 | 1285 Grey Fox Road | Suite 100 | Arden Hills, MN 55112

Blue Pearl Pet Hospital - Eden Prairie
952-942-8272 | 7717 Flying Cloud Drive | Eden Prairie, MN 55344

University of Minnesota Veterinary Center
612-626-8387 | 1365 Gortner Avenue | St. Paul, MN 55108

Animal Emergency & Referral Center of Minnesota - Oakdale
651-501-3766 | 1163 Helmo Avenue North | Oakdale, MN 55128
Are you a new or existing client*

NewExisting
How would you like us to contact you?

TextEmailPhone
Your Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Additional Owner Name (Leave blank if not applicable)

First NameLast Name
I attest that I am over 18 years of age and the legal owner of the pet (information below) and, therefore, am able to authorize all veterinary care and decisions for this pet. The additional owner on this form is also allowed to authorize all veterinary care and decisions for this pet. I understand that payment is due at time of services. I understand that a downpayment may be required on estimates or invoices over $500.
Signature*

Clear
Have we seen your pet before?*

YesNo
What is the name of the pet we are seeing today?*
If you are bringing more than one pet, request an additional form.
What is the species of the pet we are seeing?*

DogCatOther
You selected 'other'. Use the space below to tell us your pet's species.
What is your pet's birthday or approximate age?*
Is your pet male or female?*

MaleFemaleDon't know
What color is your pet?*
Is your pet spayed or neutered?*

YesNoI don't know.Not applicable
Is your pet microchipped?*

YesNoI don't know.Not applicable
Enter your pet's microchip ID here. Include the manufacturer's name.
Medical Note

Microchips are passive, non-reactive devices slightly larger than a grain of rice. They are placed just underneath the skin of your pet where they exist painlessly for a lifetime. They ensure that a lost pet can be instantly identified and reunited with his or her pet owner. They contain no chemicals or power source. They are not radioactive. Microchips are an extremely affordable, nearly infallable way to make sure that your pet will never be lost or fall into the shelter system. Talk to us if you want us to implant a microchip. The procedure can be done during a regular office visit without anesthesia.
Do you have a copy of your pet's medical records?*

YesNo, but I will have my vet send them to northpawsvet@gmail.comNot applicable, this is my pet's first visit with me to a veterinarian.
If you remember the last time your pet had vaccines, list each and the date that it was most recently administered.
If you have an electronic version of your pet's records, upload them here.

Cancelof
Do you want us to contact your veterinarian to acquire your pet's previous medical history?*

YesNoNot applicable
Practice Name*
Practice email
example@example.com
Practice phone number
Please enter a valid phone number.
Contact email to acquire records
Some veterinarians will only send records to the medical owner. Please list the email that you have on file with your previous vet and we will request that the records are sent to you.
Please tell us anything we should know about your pet such as if he or she is blind, deaf, scared to come to the veterinarian, aggressive, etc. It is okay to leave this field blank.
How did you find out about us?

Walk by or signageReferralFacebookInstagramGoogle searchOther
Please give us the name of the person that referred you, so we can thank him or her.

First NameLast Name
Tell us about your Google search
Do you remember the keyword or phrase you used? If other veterinary hospitals came up in the search, why did you choose ours? Thank you again for your help in this area!
You chose 'other'. Can you tell us more about how you came to our business?
We use information about your search engine use, your keywords, and the other information you provide to improve our marketing. Thanks in advance for your help.
Please tell us the reason(s) for your Urgent Care visit. Please include when the condition(s) began and how you may have been trying to treat.
Reason for today's visit*

Wellness examA puppy, kitten, or newly adopted petA medical condition that requires careMedical recheckTechnician appointment
Congratulations!

Welcome to North Paws! Whether you have a new puppy or kitten, an adopted adult, or other kind of pet we will get you started off on the right foot...errr paw! Bring any questions that you have:
- What kind of food should I feed my pet?
- What kind of litterbox is best?
- How can I introduce my new cat to the one I have at home?
- How should I socialize my new pet?
- How can I potty train my new puppy?
You can also send your questions to us before your visit and we'll be sure to have all the information you need ready when you arrive for your appointment. Thank you for choosing us to care for your pet!
Important

Medical rechecks are only available for patients that have been seen and previously treated by a North Paws veterinarian in the past 30 days. If your pet requires a recheck, but was seen by another veterinarian or if it has been longer than 30 days, please select 'A medical condition that requires care' from the previous field.
What medical condition are we rechecking?
Use the space above to briefly tell us what we are rechecking and any other additional information you believe is important for us to know.
What is the treatment, procedure, surgery or diagnostic(s) your pet is here for today?
Tell us more about the condition (s) you would like us to address today. Include when the condition began, whether it is getting worse, better, staying the same, etc.
Explore our Annual Care Packages and SAVE

Annual care packages reduce the cost of all the services your pet regularly receives during an annual checkup. Find out more.

Annual Care Services

During your pet's exam, we'll talk about any of the following care options that we think are right for your pet. Keep in mind, most of these are included in the Annual Care Package discussed above.

Fecal Analysis

IMPORTANT: Please bring a stool sample for your pet's appointment.

Approximately 1-5% of all dogs and 1-3% of all cats carry harmful intestinal parasites that are transmissible to humans. See laboratory statistics for our area.

Heartworm and tickborne disease test

1 in 30 dogs in our area tests positive for a tick borne disease like Lyme. We offer an affordable screen for most tick borne diseases and heartworm disease in dogs.

Feline Leukemia and FIV

Outdoor cats are at risk for feline leukemia with 1 in 50 cats in our area testing positive for the disease. It is important to either vaccinate or annually screen for this potentially deadly disease.

Vaccines

Both the dog and cat vaccines that we use at our practice have been heavily researched and are the safest on the market. If you have questions about over-vaccination or side effects, please talk to us. More.

Year-round Flea and Tick Protection

Year round prevention against fleas and ticks is strongly recommended. Ask about our current promotions to save!

Internal Organ Function Blood Test

This is an affordable test that helps us understand how your pet is aging and what we can do to keep him or her living a long, healthy life.
Fasting

If your pet is scheduled for a service the requires sedation, it's important that you followed the fasting instructions that we provided you. Answer the question below regarding fasting your pet prior to his or her procedure.
I fasted my pet according to instructions.*

YesNoNot applicable, my pet is not here for sedation
Since we last saw your pet, has the medical condition that we are rechecking or treating changed?*

ImprovedWorsenedStayed the same
Describe the changes.
We may need to contact you today while your pet is on our care. Please provide a phone number that we can use to speak to you if there is an urgent issue.
Please ensure that you keep your phone and ringer turned on in case we need to reach you.
Can we text you at the above number?*

YesNo
List the brand of food you feed and how much per day.
Please list the names of any medications you are currently administering, how much, how frequently, and last date/ time administered. Include information on any flea or tick medication given.
The above information is especially important if your pet is having an anesthetic procedure or if we are treating a chronic illness like diabetes or hyperthyroidism.
Have you noticed any change in the way your pet drinks water or eats?*

No changeEating/drinking moreEating/drinking lessDropping food out of mouth or making more of a mess when eatingUnsure
Medical Note

Dropping food out of the mouth, chewing on one side, or teeth chatter is often a sign of pain related to dental disease. During your pet's exam, we'll evaluate whether dental disease may be the source of this new behavior.
Describe the changes
Include when you first noticed the changes. Please note that a change is thirst is a very important health sign. Please don't overlook mentioning any changes in thirst that you believe are noteworthy.
Urination: Check all that apply*

No change to my pet's urine or urination habitsIncreased frequency of urinationIncreased volume of urinationThe color of my pet's urine has changed (including blood in urine)Urinating outside of the box, accidents in the house, marking, etc.
Medical Note

Male cats straining to urinate is a medical emergency. If your male cat is
- Using the litter box frequently
- Crying when urinating
- Producing little-to-no urine when positioning himself to pee
- Eliminating blood along with urine
Please call us right away to discuss emergency options.
Please give us more information on the changes you see.
Stool: Check all that apply.*

No changes to stool habitsDiarrheaMuch darker than usualFirmer than usualHaving accidents in the houseI don't know.
BRING A STOOL SAMPLE

You selected an abnormal condition. Please bring a sample of your pet's stool. You can pick it up with a plastic bag, invert the bag, tie it, and bring it in at the time of your pet's visit.
You can use this field to tell us more about the changes to your pet's stool or habits
Is your pet straining to defecate? Is there blood in the stool? What is the consistency of the stool? Etc.
Have you tried to treat your pet's stool or bowel condition on your own? If so, tell us any medications you've tried, the dosage, for how long you've been medicating the pet, etc.
Is your pet vomiting?*

YesNoOccasionally
When did the vomiting start? How frequently? What does the vomitus look like? Use the field below to tell us any information that you believe may be helpful.
Has there been any change to what your pet eats? New treats? Has your pet been housed somewhere other than your own home recently or under another person's care?*

YesNoI don't know
Is your pet coughing?*

YesNo
Medical Note

Coughing may be a sign of infectious disease. Please call us when you arrive at our hospital so that we can make sure any animals at risk of infection are cleared from our lobby. This will help us limit any kind of outbreak that may be occurring in our area. We appreciate your courtesy in keeping other patients safe.
Tell us about the coughing. Does the cough produce any phlegm? Does the coughing occur after exercise? Did it begin after a trip to a boarding facility or kennel? Any information you believe is noteworthy is helpful.
Is your pet sneezing more than usual?*

YesNoI don't know
Medical Note

Sneezing may be a sign of infectious disease. Please call us when you arrive at our hospital so that we can make sure any animals at risk of infection are cleared from our lobby. This will help us limit any kind of outbreak that may be occurring in our area. We appreciate your courtesy in keeping other patients safe.
Tell us about the sneezing. Do you believe it is seasonal or environmentally related? Related to a trip to a dog park or kennel? Any information you believe is noteworthy will be helpful.
Have you noticed any head shaking, pawing or scratching of the ears, or any indication that your pet's ears itch or hurt?*

YesNo
Tell us more about the head shaking, pawing or scratching? When did it begin? Do you notice any odor or see any discharge? Is the behavior focused on the left or the right ear or both? Any observations you believe are noteworthy are helpful.
Have you noticed any changes to your pet's eyes?*

NoTearing or dischargePawing or rubbing the face because of eye irritationChange in the size of the eye globeChange in the color of the eyeOther
Medical Note

You selected an abnormal condition with the eyes. Often changes to the eye come with irritation. In response, the pet rubs the eye and further damages it. Please make sure that we know your pet is experiencing an eye issue so that we can ensure your appointment is scheduled correctly.

Please note that some changes to eye color are a natural part of aging. At your appointment, we'll evaluate whether the changes you are seeing are impacting your pet's quality of life and whether the condition can or should be treated.
Please describe the changes that you are seeing. Is the condition in one or both eyes? If there is discharge is it colored or clear? Any information you feel is noteworthy is important.
Is your pet limping or appear to be in any pain? Does your pet seem to be reluctant to jump, climb stairs, or otherwise move where before such movement was not an issue?*

YesNo
Medical Note

Hesitancy to climb stairs or jump onto furniture, when before such an activity was not a problem, may be a sign of arthritic pain. Arthritis is common in most older dogs and cats just as it is in people. There are very safe, effective medications for both dogs and cats available to help your pet feel better. During your visit, we'll evaluate your pet for chronic, arthritic pain and make a recommendation for pain management.
Describe the changes that you are seeing.
Have you noticed an unexpected change in your pet's weight since the last time he or she was seen by a veterinarian? Remember that even 1 or 2 pounds change in a small dog or cat is significant.*

YesNo
Approximately how much weight has your pet lost? You can express it as a % or as # of lbs. When did the weight change begin?
Has your pet's activity level significantly changed since last seen by a veterinarian?*

YesNo
Describe the change in activity that you are observing. Restless behavior is as significant as listless behavior.
Is your pet having any of the following skin conditions? Check all that apply.*

Lumps or bumps that we haven't already examinedItchinessCrusts, pustules, or soresVisible signs of parasites like fleas or ticksHair lossLesionsOtherNone
Medical Note

Effective parasite treatment MUST include a way to eliminate pests on the pet and in the home. During your visit, ask us for help building a plan that will work for your home, your furnishings, your pet, and other animals in the house.
Please use this space to describe more of what you are seeing and where it is located on your pet's body.
Are you currently trying to treat the skin condition?*

YesNo
Tell us what you are doing to treat the skin condition. If it is a medication, list the name, the dosage, and how often you are administering. INCLUDE any flea or tick medications that you have tried.
Is there any other medical condition that you would like us to address today?*

YesNo
Use this field to tell us more.
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