Pre-Visit History Form

We look forward to meeting you and your pet!

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Check which signs were or are currently present and how severe they "typically" are. Please answer one response per row.

Never

Rarely

Sometimes

Often

Check areas where your pet bites, scratches, or rubs

Never

Rarely

Sometimes

Often

Check if the following treatments have been tried and if so, did they help at the time?

Yes

No

Maybe

Not tried

Are you able to give your pet the following medication?

Yes

No

Maybe

Not tried

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