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Please fill out the following questions prior to your upcoming appointment. Thank you
Sick Pet Information
Owners Name
*
First
Last
Patient Name
*
First
Last
Phone Number
Who will be here with the appointment today?
*
What is the best number to reach you/them at today?
*
How is your pet doing today? Can you describe what has been going on?
*
How long have you noticed this problem?
Any significant prior health concerns or illnesses?
Is there anything they could have gotten into at home? (Garbage, toys etc.) Ever off leash or left unsupervised?
Has there been any vomiting (hairballs for feline)? ...If yes: Is the food digested? Was there retching (regurg vs. vomit)?; frequency and consistency; have you recently changed their diet?
Any diarrhea? If yes: how often are they having diarrhea; is there any blood or mucus in the stool; have you recently changed their diet?
Any coughing or sneezing? If yes: When were concerns first noted? How frequent/day?
Any itching/scratching, lumps/bumps? If yes: When was this noticed and describe size/location/appearance.
Have you noticed any changes in their activity level (bright, lethargic, etc.)?
Any mobility concerns- limping, slowing down, troubles getting up or down, etc?
How is their appetite recently? Any changes to diets? Any changes to the way they are eating (slower, quicker, more picky, etc.)?
Any changes to water intake?
Have there been any changes in the household? (New house, new pets or people, loud noises etc.)
Is your pet up to date on vaccinations?
Is your pet currently on a heartworm/Flea and Tick program? Where do you travel with your pet? Do you walk on trails vs sidewalk?
Is your pet currently on a Deworming Program? Is your pet exposed to Wildlife or Other animals?
What medications or supplements are they given at home? (Supplements on their food, parasite prevention, essential oils in the home etc.)
DOGS: How often is your pet around other dogs? Have they recently been boarded or around other/new pets (dog parks, doggy daycare etc.)?
Has your pet been travelling outside of Grey-Bruce?
If your pet is an unspayed female, when was her last heat cycle?
Are there any other concerns/problems for the doctor to address?
What are your Goals for today’s appointment?
If you’re seeing a veterinarian for urinary concerns, please bring your pet's urine sample for analysis to detect issues like infections, kidney problems, and diabetes. (Collect a free catch urine sample in a clean container, store in the fridge until appointment, or opt for a urine collection kit with instructions.) If you’re unable to collect a urine sample, please refrain your pet from urinating outside or in the litterbox (cats only) before the appointment.
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New Clients
What to Expect
Tour the Walkerton-Hanover Veterinary Clinic
Tour the Hanover Veterinary Hospital
Make an Appointment – Hanover
About Us
Our Team
Our Pets
Sick Pet Appointment
Vaccine Appointment
Other Appointments
Services
Hanover Veterinary Hospital
Walkerton-Hanover Veterinary Clinic
Pet Health
How-To Videos
Pet Health Checker
Pet Health Library
News
Policies
Accessibility Policy
Cancellation Policy
Zero Tolerance Policy
Links
Contact