dog history questions – existing patient

Please complete this form if your dog is an existing patient at The Wild Vet. If this is your first time visiting us, please complete the New Patient Form instead.

Owner First Name *

Owner Surname *

Owner Phone Number *

Dog's Name *

Has their parasite prevention changed since their last visit? If so, please list, including when it was last given/applied:

Has their diet changed since their last visit? If so, please elaborate:

If they have any new allergies, please advise us so we can update their file:

Describe the problem, including when it started? *

Was there a recent change in environment before the problem started? *

Is this the first time your pet has experienced this problem? If it is recurring, please describe the frequency: *

Have you noticed any vomiting/regurgitation or diarrhoea? If so, describe the frequency, and when it was first noticed. *

Have you noticed any coughing or sneezing recently? If so, describe the frequency, and when it was first noticed. *

Are your dog's activity levels normal, or has there been a change in behaviour? If not, please describe: *

Has there been a recent change in thirst or appetite? If so, please describe. *

Please list any known health issues, medical problems, or long-term medications. *

Do you have any questions for the vet which haven't been mentioned in the above history questions?

THE WILD VET

Dog History Questions – Existing Patient

dog history questions – existing patient

THE WILD VET