Pre-Appointment Questionnaire

Pre-Appointment Questionnaire

Pre-Appointment Questionnaire

Pre-Appointment Questionnaire

Questions before your appointment to help us serve you better.

Owner Information

Name

Pet's Name

Phone Number

Email Address

What are we seeing your pet for? Please be specific.

What medications are your pet currently taking?

What flea, tick, and heartworm preventive is your pet on?

When was the last dose given/applied?

What is your pet's lifestyle?

Dogs:

Cats

Do they go outside?

Are they supervised?

Enclosed?

What is the name of your pet's diet?

How much do you feed them?

How often?

Is he/she eating and drinking?

Any changes?

Is he/she urinating and defecating?

Any changes?

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

Does your pet have any reactions to vaccines or medicines?

Do you have any pet insurances?

Does your pet have another veterinarian?

Upload an image of your pet (optional):

At Port Royal Veterinary Hospital in Port Royal, SC, our experienced doctors and staff are proud to offer complete veterinary medicine catered to the specific needs of your pet.