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(503) 650-1667
Online Pharmacy
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hours
location
RX
Today:
9:00 am - 6:00 pm
Open Hours
(503) 650-1667
Phone Number
418 South Beavercreek Road
Oregon City, OR, 97045
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today:2023-09-26
General Pre-Appointment Questionnaire
Please fill out the fields below prior to your pet’s upcoming appointment.
Client Name
*
Pet Name
*
Do you have any specific concerns with your pet?
Are our records up to date? If we need to call any other hospital for records please notate the name of any other hospital we should be calling here.
*
Have there been any changes in eating or drinking?
*
Yes
No
Have there been any changes in urination (amount, frequency or appearance)?
*
Yes
No
Have there been any changes in bowel movements (amount, frequency or appearance)?
*
Yes
No
Any loose stools/diarrhea?
*
Yes
No
What do you feed and how much/how often?
*
Do you have any concerns with weight loss or weight gain?
*
Weight Loss
Weight Gain
Normal
Any concerns about stiffness, soreness or pain?
*
Yes
No
Have you noticed any coughing or sneezing?
*
Yes
No
Have you noticed any lumps or bumps?
*
Yes
No
If your pet is a feline are they indoor / outdoor?
Outdoor Cat
Indoor Cat
Not Applicable
Any changes in energy level?
*
Yes
No
Is your pet taking any medications, either prescribed, supplements or over the counter? If so what?
*
If your pet is physically healthy would you like to discuss and update vaccines today?
*
Do you need any of the following while you are here for your appointment?
*
Heartworm Prevention
Flea & Tick Prevention
Medication Refill
None
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