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Canine Annual Physical Questionnaire
Thank you for taking the time to answer these questions. This will help our Veterinarians understand your dog's diet, lifestyle, and environment.
Name
*
First
Last
Pet's Name
*
Is your dog on any medications or supplements?
*
Yes
No
If on medications and supplements, please list.
Appetite
*
Excellent
Good
Picky
Poor
Food Type
*
Kibble
Kibble & canned
Canned only
Raw
Food Brand
*
Diet Frequency
*
Once Daily
Twice Daily
Three Times Daily
Water Consumption
*
Drinks normal amount
Drinks excessive amount
Doesn't drink a lot
Activity Level
*
Normal
High energy
Sedentary
Do you have any other pets in your home? If so, please list:
*
Do you board your dog or go to a grooming facility, obedience school, leash free parks or pet shows?
*
No
Yes
Does your dog travel with you to destination vacation places (cottage, out of province, USA, etc.):
*
No
Yes
If they do travel with you, please indicate where:
Does your dog hunt?
*
No
Yes
If your dog does hunt, does (s)he eat their prey?
No
Yes
Does your dog vomit?
*
My dog does not vomit
My dog vomits occasionally
My dog vomits excessively
Does your dog persistently cough?
*
My dog does not cough
My dog coughs occasionally
My dog coughs excessively
Does your dog persistently sneeze?
*
My dog does not sneeze
My dog sneezes occasionally
My dog sneezes excessively
Does your dog persistently itch?
*
No
Seasonally
Year round
If your dog does itch, please indicate the location(s) on their body:
Has your dog experienced any mobility issues?
*
No
Yes
On occasion
If lameness has been noticed, please state which leg(s) and the duration.
Have any fleas or ticks been noticed recently?
*
No
Yes
Do you apply flea prevention?
*
Yes
No
Do you give heart worm prevention?
*
Yes
No
Do you get skunks, raccoons, or rodents in your yard or neighbourhood?
*
Yes
No
Does your dog have access to rivers, lakes or ponds?
*
Yes
No
Have you noticed any lumps you would like to have checked? If so, please include their approximate locations on body:
*
Our clinic is 'Fear Free' and the veterinarians and team take into account not only your pet's physical well-being, but also their emotional well-being.
During past veterinary visits, what level would you classify your pet as on the Spectrum of FAS (Fear, Anxiety and Stress)?
*
FAS 0
FAS 0-1
FAS 1
FAS 2
FAS 3
FAS 4
FAS 5
Should you have any additional concerns, please include them here:
Lastly, please describe which number best describes your pet's stool?*
*
1
2
3
4
5
6
7
Thank you for your time in helping us understand your pet better. Together we can continue to preserve that special bond!
Home
Welcome New Clients
Request an Appointment
Request a Refill
Feline Annual Physical Questionnaire
Canine Annual Physical Questionnaire
About Us
Our Story
Meet Our Team
SPCA Wish List
Fear Free
Services
Surgical Care
Canine Spay Surgery
Canine Neuter Surgery
Feline Spay
Feline Neuter
Dentistry Procedures
Physiotherapy
Welcome Puppies & Kittens!
Senior Wellness Screening
Physiotherapy
Boarding
Professional Grooming
At Home Euthanasia
Pain Management
K-Laser Therapy
Annual Care
Early Detection & Wellness Plans
Pet Health
Pet Health Library
Symptom Checker
How-To Videos
News
Blog
Contact Us
Vet Store
Petriage