Sick Pet Questionnaire

Please answer the following questions as accurately and with as much detail as possible.

Please check all that apply
Please select all that apply
Spayed or Neutered?
Are vaccinations current?

IF THE DOCTOR DEEMS IT NECESSARY TO BETTER DIAGNOSE YOUR PET, DO YOU APPROVE THE FOLLOWING TESTS/PROCEDURES?

Labwork
(may include blood tests and/ or urinalysis)
Imaging
(may include X Rays and/or ultrasound)
Sedation
Please select any areas you are concerned about and would like to address during your visit:
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