Prior to your pet’s first exam or annual physicalName* First Last Phone*Pet's Name* Email* List all of your concerns for the doctor exam and treatment plan:*A history of seizures, major diagnoses and/or surgeries:*Current medications/supplements, and how much of each you’re giving (indicate if refills are needed):*Are you giving heartworm & flea/tick prevention as directed?*A description of daily activity, and general exercise regimen:*Are vaccinations and lab work current? Please list dates of most recent Rabies, Fecal and Heartworm test?:*List microchip ID or mention if you’d like one implanted for your pet:*Are there any services like acupuncture/ chiropractic care/ laser/ ozone, or vitamin /glucosamine therapies that you’d like for us to proceed with during your pet’s appointment?*Would you like your pet to have an ear cleaning, nail trim, or anal sac expression during their visit? Ear Cleaning Nail Trim Anal Sac Expression
