• New Patient History Form (Dog)

  • Patient Sex*
  • Where did you find us?*
  • Where did you get your pet from?*
  • Is your dog a show dog?
  • Is your dog a breeding dog?
  • Is your dog a hunting dog?
  • Is your dog an agility dog?
  • Is your dog a service dog?
  • What type of food is it?*
  • How is your pet's appetite?*
  • Is your pet on any medications or supplements?*
  • Has your pet been diagnosed with any of the following? (check all that apply)
  • Has your pet ever been hospitalized?*
  • Any previous extractions or oral surgery?*
  • Has your pet been diagnosed with any of the following? (please check all that apply.)
  • Do you brush your pet's teeth?*
  • How does your pet like it?*
  • Does your pet have a history of being fractious, aggressive or difficult to handle at a veterinary office?

  • Many pets are anxious and nervous in a clinical setting. If you feel your pet would benefit from anti-anxiety medications please speak with your primary care veterinarian prior to this appointment. We would like your pet to have the best experience possible. 

  • May we use photos of your pet and their teeth for social media purposes? We will never use your name, just your pet's first name.*

  • To help our veterinary team provide thorough and efficient care, we may use AI-assisted technology to help document your pet’s visit and organize medical information. By continuing with your pet’s visit, you acknowledge that AI-assisted technology may be used to assist with medical record documentation.

  • Should be Empty: