New Puppy Appointment Questionnaire

Name: Lockerby Animal Hospital
Telephone: 705-522-4555

Congratulations on your new puppy and welcome to Lockerby Animal Hospital! We are very excited to meet him or her! Thank you for taking out the time to fill out our questionnaire prior to your appointment. This allows us to get to know you and your puppy a little before the appointment so we can focus in on the things that really matter to you. Please ensure you bring a sample of your pet’s stool to the appointment (about a teaspoon size, fresh within the last 24 hours) so we can test for intestinal parasites. Please feel free to call 705-522-4555 or email info@lockerbyanimalhospital.com if you have any questions.

Owner/Co-Owner First and Last Name(s) *

Pet's First and Last Name *

Pet's Date of Birth

Appointment Date and Time

Are you interested in connecting with the veterinarian/RVT staff by video on your phone while you wait in your car for your pet's appointment (ie. telemedicine)?

Who will be bringing your pet to the appointment? (If this person is not the owner, please indicate their relationship to you and if they are able to make medical and financial decisions on your behalf).

What is the best phone number for the veterinarian to call once the examination is complete to discuss exam findings and diagnostic/treatment recommendations? *

When and where did you adopt your puppy?

Do you have documentation from the breeder/rescue group?

If yes, please email it to info@lockerbyanimalhospital.com or bring it to the hospital at the time of the appointment.

Has your puppy had any previous vaccinations or deworming?

If your puppy has had vaccines or deworming, please list the date and vaccine/dewormer.

Do you have other pets at home?

If yes, how many and what species? How are they accepting the new puppy?

Is your puppy eating and drinking well?

If you answered no to the above, please elaborate here.

What are you currently feeding your pet? Please include name, amount, frequency and all treats.

How is house training going?

Is your puppy still having fecal/urinary accidents?

Are you crate training your puppy?

If yes, how is crate training going?

Is your pet scratching or do they seem itchy?

If yes, please describe where they are scratching and how frequently.

Have you noticed any vomiting, diarrhea, coughing or sneezing?

If yes to any of the above, please give details.

Please help us understand your pet's lifestyle. Will they be spending time outdoors (camp, hiking, walks, swimming) or will they mainly be an indoor pet? Will they be travelling? If yes, where will they travel?

Will your pet be groomed or boarded on a regular basis?

Is your pet currently on any medications or supplements? If yes, please list below.

Have you signed your pet up for health insurance?

Do you have any specific concerns with your pet that you would like addressed at your appointment?

New Puppy Appointment Questionnaire

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Lockerby Animal Hospital

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