New Puppy Exam History

Please complete this form as completely as possible before your visit.

Owner's Name *

Email *

Phone *

Pet's Name

Where did you get your puppy?

How long have you had your new puppy?

Has your pet received any medical treatments (vaccines, deworming, etc.)? Please bring a copy of these records with you.

Have you noticed any issues/problems with your new puppy?

If yes, please describe the issues:

What type of training are you doing for your puppy?

What percentage of time will your pet spend outside?

Have you started flea/tick and heartworm prevention?

Do you have any other pets?

Are they up to date on vaccines, heartworm and flea/tick prevention?

Have you signed up for dog insurance?

If not, are you interested in getting information about it?

Will your pet go to the following: Boarding, grooming, dog parks?

What are you currently feeding and what is the amount you're giving?

Would you like some information about Care Credit and/or Scratchpay?

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