• GI EXAMINATION - Virtual Check-In & Patient History

    The following health history/risk assessment is a comprehensive look at your pets most recent GI health history at home. If we are performing a complete exam focused on gastrointestinal health or condition this focused history will be helpful in identifying your pet's most pressing concerns. It will take about 10-15 minutes to thoughtfully complete, and is best completed by your pet's primary caregiver. Completing this intake to the best of your ability should help us ensure accuracy and efficiency when arriving at a patient treatment plan
  • Appt Date If Known
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  • GENERAL INFORMATION

  • Patient Species*
  • Lifestyle*
  • Canine Activities or Occupation

  • Feline Activities or Occupation
  • Lifestyle III - Protozoal Disease Risk
  • Lifestyle II - Housemates and Animal Neighbors*

  • Resources

  • Vitamins, Supplements, Over-the-Counter Remedies or Medications*
  • My Dog's Heartworm Prevention of Choice is:*

  • My Dog's External Parasite Prevention (Flea/Tick Etc) of Choice is:*

  • My Cat's Parasite Prevention (Flea/Tick, Heartworm, Intestinal Parasites or Ear Mites Etc) of Choice is:*

  • Resources - Drinking Water - Cat

  • Health Condition and GI Signs

  • Please select all that apply to the best of your knowledge

  • Allergy History as Diagnosed by a Veterinarian - Select all that apply*

  • Current Apparent Attitude/Disposition*
  • Vomiting?*
  • You Indicated that Your Pet is Vomiting on an Acute or Chronic Basis - Please select all that apply

  • Parasite Screen - I have noticed the following within the last month:

  • Regarding Your Pet's Appetite and Levels of Thirst*
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  • Regarding Your Pet's Bowel Movements*
  • You Indicated that Your Pet Has had Diarrhea on an Acute or Chronic Basis - Please select all that apply

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  • Patient Behavior & Finish

    Sometimes changes in a pet's behavior can indicate pain, illness, or injury. We have just a few more questions to ensure that we have as much information we can use to help your pet. Remember they can't speak and tell us what's wrong, so we count on you and thank you for your patience!
  • Behavioral Screen*

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