Please Note: We will be closed on Thursday, November 28th in observance of Thanksgiving!

Rehabilitation Initial Exam Questionnaire

Make the most of your next appointment by saving time! Before your appointment, fill out your form from any device at any time.

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Rehabilitation Initial Exam Questionnaire

Name *

First

Last

Email *

Phone *

Pet's Name *

What is your main treatment goal for your pet’s rehabilitation appointment? *

What is your pet’s current daily exercise routine? *

Has there been any recent change to exercise and activity level? *

Why? (hardwood, in

Does your pet have a current or previous history of mobility issues (such as intermittent limping, arthritis, surgeries, etc.)? If yes, please explain. *

What flooring is in your home (hardwood, area rugs, carpet, etc)? *

Does your pet slip or slide in your home? *

Are there any stairs in your home? *

Does your pet have trouble going up and down stairs? *

What is your pet’s diet? How often do they eat? *

Does your pet get treats? What kind? *

What current supplements do you give your pet (brand name, strength, frequency)? *

What are your pet’s current prescription medications (name, strength, frequency)? *

Have you recently stopped a prescription medication or a supplement? Why? *

Does your pet have sensitivities to any medications or supplements? *

Does your pet have any food or gastrointestinal sensitivities? Any treats we should avoid? *

Does your pet have any history of cancer? *

Does your pet have any history of seizures? *

Does your pet have any history of nipping or biting a person or other animal? *

Has your pet ever needed to be muzzled or sedated due to behavior for a vet appointment? *

Does your pet prefer sunny/warm areas or cool/shady areas? *

Rehabilitation Initial Exam Questionnaire

Rehabilitation Initial Exam Questionnaire

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