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ABOUT
About Our Clinic
OUR TEAM
Dr. Ashley Bernauer
Dr. Graeme Linton
Dr. Sheila Finch
Dr. Thisuri Eagalle
Dr. Nancy Louis
Dr. Jared Watson
Dr. Hayley Doody
Dr. Tara Westworth
Sheena
Joyce
Shayla
Mya
Megan
Mykena
Brandy
Jolene
Kevin
Kim
Ezrah
Nicola
Barb R
Sage
Barb J
Colleen
Kirstin
Rachel
Lynette
Hanna
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Canine Nutrition Form
Help us get to know you and your pet!
Client Info
Client First Name
Client Email
Client Last Name
Client Phone Number
Preferred Method of Contact
Phone
Email
Patient Info
Patient Name
Age
Breed
Sex
Male
Male Neutered
Female
Female Spayed
How long have you owned or looked after your dog?
Have you owned a dog(s) before?
Yes
No
Do you have other pets in the household? Please specify.
How active is your dog? Please be specific and note things that are done on a regular basis (daily and weekly)
Diet
Please describe what your dog does daily. Where do they spend most of their time, and how do these activities change throughout the year?
How would you describe your pet’s energy level?
Couch Potato
Low Energy
Medium Energy
High Energy
Hyperactive
How many meals per day do you feed your pet?
How much do you feed per meal?
Pet Food Brand
Pet Food Formula
Does you pet have any known allergies?
Do you feed your dog anything in addition to their meals? Example: Treats, Veggies, Toppers etc. If so, how much per day?
Activity Level
Sedentary - Spends most of the day indoors/little to no play
Low - Less than 1 hour of activity or play per day
Medium - 1-3 hours of activity or play per day
High - Over 3 hours of activity outside per day
Medical Information
Please bring any medications or supplements your pet is on to your first appointment.
Please select all that apply to your pets tempermant.
Human Reactive
Dog Reactive
Anxious/Nervous
Unsure of New People
Needs Space
Friendly
Calm
Excitable
Food Motivated
Toy Motivated
Other
Does your pet have any known medical conditions?
Please list any medications your pet is on. Please include the dose.
Please list any supplements your pet is on. Please include the brand & dose.
Do you beleive your pet would benifit from receiving calming medication prior to appointments?
*
Yes
No
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