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New Pet Form
Critter Care Animal Hospital New Pet Registration Form
Today's date: *
Pet's First & Last Name: *
Approximate Date of Birth/Age: *
Species: *
Sex: *
Breed: *
Color and/or markings: *
Has your pet been microchipped? *
Previous veterinarian's information (if known):
How long have you had your pet? *
Reason for today's visit? *
Since bringing this pet into your home, have you observed any of the following? *
Has your pet been eating regularly? *
How many times a day are you feeding your pet? *
What type of food and how much do you offer at each meal? *
Does your pet get any treats, snacks, or table scraps? *
If you answered yes to the previous question, please briefly describe:
Do you have any other pets in the household? *
If you answered yes to the previous question, please list their name(s) & species:
Will your pet be around small children? *
If it has not already been done, are you planning on spaying or neutering your pet?
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Has your pet been treated for any illness if the past year? *
Please list any current issues, medications & dosing instructions:
Has this pet been on any form of Heartworm prevention while in your care? *
If you answered yes to the previous question, please list the name of the prevention being given:
Are you interested in purchasing Heartworm prevention for your pet today? (Heartworms are a common parasite for dogs, especially in the southern stages. Dogs & cats are infected via mosquito bites. In the Houston area, this can occur any time of year. Heartworms will cause heart and lung disease or even death in some cases. We highly recommend Heartworm prevention in ALL dogs and cats 8 weeks of age or older throughout their lifespan.) *
Are you interested in purchasing flea prevention for your pet today? (Fleas are a very common problem for pets in this area. Fleas can cause skin irritation and allergies, as well as infect your pet with other diseases. We suggest that all dogs & cats be on flea prevention.) *
Are you interested in having your pet screened and treated for these parasites today? (Virtually all puppies and kittens are born with an intestinal parasite. These parasites live in the intestines and can cause disease for your new pet, other pets in the house and even people. Even if your pet has been wormed by a breeder, at a pet store, or a previous veterinary hospital, it is possible that these parasites are still present in your pet. We strongly recommend that all new puppies & kittens in a household be tested at least once and dewormed twice for these parasites.) *
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