Dermatology Exam: Pre-Visit Questionnaire
Thank you for allowing us to care for you and your family. In an effort to better care for your pet, we ask that you complete this Pre-Visit Questionnaire so that our team can review your pet's medical history. Please take a moment to answer the following questions prior to your appointment.
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Reason for visit
How did you hear about Animalia?
Does your pet have a history of any of the following?
Biting or licking paws
Irritated skin (itching/scratching)
Does your pet have any previously diagnosed medical conditions?
Is your pet currently taking any medications or preventative medications? What dosage?
Has your pet had any surgeries other than his/her spay or neuter?
What is your pet's current diet?
Does your pet or anyone in your household have a food allergy?
Please provide the name and phone number of previous clinics where we can obtain medical records. This information can also be emailed directly to us at email@example.com
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