Owner/Co-Owner First and Last Name(s) * Pet's First and Last Name * Pet's Date of Birth Appointment Date and Time 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? * Did you have any concerns about your puppy after his/her last vaccines? Please Select Yes No If yes, please tell us more. Is your puppy eating and drinking well? Please Select Yes No If you answered no to the above, please elaborate here. How is house training going? Is your puppy still having fecal/urinary accidents? Please Select Yes No Would you like to have your puppy vaccinated against Kennel Cough or Leptosporosis at this visit? Please Select Yes No I don't know
Kennel Cough (also known as canine infectious tracheobronchitis) is a highly contagious respiratory disease. Dogs commonly contract kennel cough at places where large amounts of canines
congregate, such as boarding and daycare facilities, dog parks, training groups, and dog shows. Dogs can spread it to one another through airborne droplets, direct contact (e.g., touching noses), or
contaminated surfaces (including water/food bowls). It’s highly treatable in most dogs but can be more severe in puppies younger than six months of age and immunocompromised dogs.
Leptospirosis is an infectious disease that causes serious illness in dogs, other animals, and people. The disease is caused by spiral-shaped bacteria called leptospires that live in water or warm, wet
soil. Initial signs of leptospirosis include fever, lethargy, and lack of appetite. Left untreated, it can develop into a more severe, life-threatening illness that affects the kidneys, liver, brain, lungs,
and heart. Please ask our team for more information if you are unsure if these vaccines are appropriate for your pet based on their lifestyle.
Do you have concerns regarding any behaviours that have arisen since our last visit? Please Select Yes No If yes, please give details. Do you have any specific concerns with your pet that you would like addressed at your appointment?