New Client Form – Canine

Owner Information

Owner Name
Address
How did you hear about us?

Pet Information

What kind of food does your pet eat?
Science Diet, Royal Canin, Purina, etc.
Variety / Flavor?
How often do you feed your dog?
Do you give your dog treats, bones or other chews?

Medical History

How would you describe your dog's weight?
How active is your dog?
On average, how much time does your dog spend outside per day?
Do you use a crate or kennel with your dog?
Do you use flea or tick preventatives with your dog?
Do you use it all year round?
Do you give your dog heartworm preventatives?
Do you use it all year round?
Does your dog have frequent explosure to other dogs?
If yes, where?
Have you ever known your dog to bite?
On a scale of 1-5, how fearful is your dog about coming to his/her vet appointment?
I have concerns about:
We want to know how we can serve you and your pet(s) better. What services would you most likely utilize if offered?