Pet Information Sheet printable pdf download

Pet Information Sheet

PET INFORMATION

PET’S NAME ____________________________________________________________

BIRTH DATE OR AGE ____________________________________________________

CANINE / FELINE / OTHER ________________________________________________

BREED__________________________________________________________________

SEX ___________________________NEUTERED OR SPAYED?__________________

LAST HEAT CYCLE (FEMALE ONLY)_______________________________________

COLOR__________________________________________________________________

MEDICAL HISTORY:

Who is your pet’s previous veterinarian? ________________________________________

May we contact them for medical information if needed?____________________________

Has your pet had any previous medical or surgical problems? If yes, please explain

________________________________________________________________________

What kind of food does your pet eat?___________________________________________

Has your pet ever had an allergic reaction to a medication? _________________________

Has your pet ever had a reaction to a vaccine? ___________________________________

Is your pet currently on any medication?_________________________________________

NEW PUPPIES/KITTENS:

Where did your pet come from? (Circle one)

Pet Store

Private Home

Breeder

Stray

Humane Society

Pet Information Sheet