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Hours & Contact
Monday - Friday: 8:00am - 6:00pm
Saturday & Sunday: CLOSED
(713) 527-0489
[email protected]
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Appointment Check-in Form
Client's First Name
Client's Last Name
Patient's Name
What phone number will you be available for the doctor to call during your appointment?
Email
Reason for today’s visit/concerns/questions:
When did you first notice these symptoms?
How often is this happening?
Any coughing, sneezing, vomiting, or diarrhea?
Has your pet ever been treated for these or similar symptoms before?
Have there been any other changes in your pet (appetite, water consumption, stools, urinations, lethargy, etc.)?
Have there been any changes in your pet’s environment recently (family member, move, renovation, using a new cleaner, etc.)?
Is your pet on any medications?
Yes
No
What brand of food do you feed? How many cups a day?
Does your pet have any anxiety or fear triggers (ex. fireworks, strangers)? *
Yes
No
Does he/she have any anxiety about coming to the vet?
Yes
No
How do you feel we could improve their vet visit? Or your visit?
What motivates/excites your pet? Toys? Food?
What flavor treats/foods does he/she like? Cheese? PB? Meat?
Does your pet have any food allergies?
Yes
No
Do you need any preventatives?
Heartworm Pills
Heartworm Injectable
Flea/Tick pills
How many flea/tick pills do you need?
Do you buy online? -- we can email you a script for our online pharmacy
Yes
No
Would you like a nail trim today?
Yes
No
Have you checked out our wellness plans?
Yes, I would like to sign up
Please discuss them further with me
I have reviewed them, Not interested
I have not looked at them
I am already enrolled
Do you consent to us posting photos/videos of your pets on our website/social media?
Yes
No
Owner's Signature
Sign above
Date
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