Appointment Q&A - Cat and Dog Hospital of Portland

Client Name:*

Pet Name:*

Has there been any vomiting, diarrhea, sneezing, or coughing recently?*

Please respond yes or no, and provide short details.

How is their appetite? If there are changes, please explain:*

What are they currently eating each day? IE: brand, type, amount*

How is their energy? If there are any changes, please explain:*

What current medications are they taking? How much and how often are they taking their meds? Are they on flea control?*

Do you need any medication refills?*

Please specify which refills are needed

Does your pet have a history of needing a sedative for a previous vet appointment?*

Any new concerns happening?*

How long has this concern been happening?

Any questions for the doctor?*

(Cat Only) Lifestyle: Is your kitty indoor/outdoor? Do you have a Catio? Do you walk them on a leash? Are they out hunting? Please explain:

(Cat only) Any changes in litterbox habits? If there are changes, please explain:

Name

This field is for validation purposes and should be left unchanged.

Appointment Q&A Form