Canine Wellness Form

Canine WELLNESS visit

Dog's with health concerns and annual vaccinations
You are receiving this form in advance of your pet's appointment at Bendigo Pet Vets to allow us to improve our efficiency and communication with you.

Feel free to communicate questions or concerns prior to your visit.
Date of Appointment

MonthDayYear
Date
Your First Name & Surname
Your Pet’s Name
Please provide us with your best contact number
Format: 0000-000-000.
Please park outside the fence and bring your dog in on a leash inside the gated area. If there are other clients or patients in the fenced area you can wait for a team member to help you check in. Please let us know if we can better accommodate you or your dog during the visit.

Other
Your dog is scheduled for a WELLNESS visit, what questions or concerns would you like to bring to the doctor’s attention?
Current medications or supplements (other than heartworm prevention)
What are you currently feeding your dog?
Dental / Oral health

Other
Heartworm Prevention
Flea and Tick Treatment / Prevention
I have noticed

Other
Need any further help? Medication refill, Food refill, Other?
Are there images or videos that would be helpful for todays visit?

Cancelof
Should be Empty:

Canine WELLNESS visit