Pre-Consult Questionnaire | Woodhamlanevets

IMAGING SUITE

Pre-Consultation

Questionnaire

Please complete these questions before your appointment, to assist us in providing the highest level of care for your pet.

Your Pet's Name and Surname

Your Pet's Birthday

Is your pet:

Female Entire

Male Entire

Male Neutered

Female Neutered

Your Pet's Insurance Company

When did you last use a wormer, and can you tell us the name, if you can recall it?

When did you last use a flea product, and can you tell us the name, if you can recall

Can you recall when, approximately, your pet last had a vaccination or titre test?

What does your pet normally eat? Tick all that apply

Dry (kibble/biscuits)

Wet (canned meat)

Raw

Other

How do you stay organised, and budget for your pet's preventetive healthcare throughout the year?

Is your pet a member of our Healthy Pet Club?

Yes

Not yet, but I'd like to join

When did you pet last have a dental hygeine check-up or procedure?

My pet's breath:

Is lovely, and smells great

Can be a bit smelly

Is getting smellier

Is really smelly

Have you noticed any changes in your pet's behaviour or demeanour? Slight changes can be an early sign of a problem, and you know your pet better than anyone! By telling us now, you may help us detect a condition sooner. Tick all that might apply.

Weeing - increased amount/decreased amount/more or less frequently/change in colour/change in smell

Pooing - constipation/loose faeces/mucous/blood

Activity levels - increased/decreased

Drinking - increased/decreased/changed

Appetite - increased/decreased/changed

Stiffness noticed after exercise, or after resting/sleeping

Scratching at ears/skin

Coughing or Sneezing

Thanks for sending to Woodham Lane Vets, one of our vets will take a look shortly!

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