Wellness Consultation Review
Please take a moment to answer the following questions prior to your scheduled appointment so that we may partner with you in optimizing your pet's health.

As a reminder:
1. When you arrive at the Clinic for any reason, PLEASE REMAIN IN YOUR VEHICLE and contact the clinic at (541)548- 1048 and a staff member will provide you with further instructions. If you are unable to contact us by phone when you arrive, please let the receptionist know when you make your appointment and we can assist you with other options.

2. If you are coming in with a patient for a wellness exam and vaccinations, a staff member will come out and retrieve your pet and the doctor will complete the examination and vaccines and return your pet to you at the vehicle.

3. You may also opt to admit your pet at NO CHARGE and return later in the day for your pets Discharge. The doctor will contact you after the examination is completed.
Email address *
Your First and Last Name
Pet's Name
Nutrition
We will make a nutritional assessment and recommendation based on our examination.
What brand of food are you currently feeding ?
According to the AAFCO Statement (Nutritional Adequacy) on the bag, what is the diet considered?
Example: Animal Feeding Tests using AAFCO procedures substantiate that "X Brand Food" provides complete and balanced nutrition for "growth/maintenance/all life stages"
Growth
Maintenance
All Life Stages
Please Choose One
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Disease Prevention
We believe that vaccination should be individualized based on the risk and lifestyle of the patient.
Risk Factors
My Pet has NO contact with other animals
My Pet has OCCASSIONAL contact with other animals (groomed, walks, etc)
My Pet has FREQUENT contact with other animals (dog parks, boarding, travel, etc)
Please Choose One
Clear selection
Parasite Control
Will your pet leave Central Oregon at least once this next year?
Yes
No
Please Choose One
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What product(s) are you currently administering for internal and external parasite control?
Interceptor Plus (dogs)
Bravecto (flea/tick)
Profender (cats)
Frontline (flea/tick)
Pyrantel
Choose all that apply
How frequently are you administering the product(s)
Monthly
Quarterly
Yearly
Other
Choose all that apply
Behavior
Is your pet currently exhibiting behavioral problems?
Fears/Anxieties, Aggression or Manners problems
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