New Patient Form – First Appointment – River Road Animal Hospital

Pet's Name*

First Last

Date of Appointment*

Cell Phone Number - must be reachable during appointment*

Email Address*

How long have you had your new pet for?

Where is your pet from? (Breeder, humane society, etc...)

If your pet is from a breeder, did you have the opportunity to meet the parents?

Is your pet up to date on vaccinations?

Yes
No

Has your pet been dewormed?

Yes
No

Is your pet's house training or litter box training progressing well?

Yes
No

For kittens - What type of litter do you use?

Any vomiting or diarrhea?

Yes
No

Any coughing or sneezing?

Yes
No

What type of food and treats does your pet get? How often and how much?

Has your pet's diet changed recently?

Any change in appetite?

Any change in thirst or urination?

Any itching or chewing?

Yes
No

Any limping or soreness?

Yes
No

Behavioural concerns?

Is your pet on any medications or supplements? Please list with dosages.

For puppies - Do you plan to have your puppy on trails? Cottage? Rural?

For kittens - Do you plan on keeping your kittens indoors only?

Do you have any other pets in your household?

Will you be travelling outside of Canada with your pets?

Photo Release Consent

Yes
No

I hereby give River Road Animal Hospital permission to take photographs and videos of my pet for the purpose of posting on River Road Animal Hospital's social media accounts and their clinic website.

New Patient - First Appointment