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Pet Health Questionnaire
Please fill in this questionnaire and submit it when completed.
Pet's first and last name:
Appetite:
Normal
Increased
Decreased
Any weight loss or weight gain observed?
Yes
No
Current food:
Dry food brand & amount:
Canned food brand & amount
Treat name and table food:
Any food concerns?
Where do you purchase your pet's food?
How would you describe your pet's activity level:
Non-active
Moderately active
Very active
How would you describe your pet's weight?
Too thin
Normal weight
Gained a few pounds
Needs to lose weight
Please select the image below from 1 to 5 that best describes your pet
How would you describe your pet's breath?
Not bad for a dog's breath
Unpleasant
Really bad ( needs mouthwash)
Current medications & supplements:
Home
New Clients
What to Expect
AHAA Accreditation
FAQs
Testimonials
About Us
Team
Staff Continuing Education
Contact
Late cancellation / No Show Policy
Emergency Process
Pet Photos
Community Events
Upcoming Events
Awards
Services
Preventive Care
Puppies and Kittens
Senior Pets
Surgery
Radiology
Dentistry
Anaesthesia
Pain Management
Referrals
Pet Insurance
Nutrition
Exotic Pets
Euthanasia
Rehabilitation
Ultrasound
Pet Health
Articles
Illustrated Articles
How-To Videos
Pet Health Checker
Puppy Information
Kitten Information
News
Links
Pet Portal
Forms
Pet Health Questionnaire
Mature Pet Questionnaire