Pet Care Professionals, Inc.

2651 Union Ave. Extended, Memphis, TN 38112

901-324-0202

901-324-3333 (fax)

Monday - Friday 7:00am to 5:30pm, Saturday 8:00am to 12:00pm

Sunday 3:30pm to 4:30pm (boarding pick-ups only)

Pet Care Professionals
2651 Union Avenue Extended
Memphis, TN 38112
ph: 901-324-0202
fax: 901-324-3333
pcp_vets@bellsouth.net

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Pet History Form

Please fill in the following questions and information to the best of your knowledge. We will use this information during your pet's exam to better assess any needs your pet may need and keep him/her healthy.

*Client Name:

*Pet Name:

Email:

If you would like reminders sent to you via mail and e-mail, please fill in

*Is your pet spayed / neutered?

Yes No

*What heartworm preventative do you use?

Heartgard Trifexis Other None

*What flea preventative do you use?

Vectra Trifexis Frontline Advantage Other None

*Do you need any refills on your heartworm/flea preventatives?

Yes No

If yes, which ones?

*Is your pet currently on any medications?

Yes No

If yes, please list them and indicate if any refills are needed:

*Is your pet allergic to any drugs/medications?

Yes No

If yes, please indicate which ones:

*Do you wish for your pet to have wellness bloodwork perfomed today?

Yes No

Click here to view why your pet should have wellness bloodwork.

*What diet do you feed your pet?

*Is your pet's appetite...

Increased Normal Decreased

*Is your pet's weight...

Increased Stable Decreased

*Is your pet... (check all that apply)

Vomitting Having diarrhea Constipated Drinking more Urinating more Coughing Sneezing Shaking head Scratching Scooting None of the above

*Have you noticed any lumps that we need to check out?

Yes No

If yes, please describe where, how long its been there, and is it getting bigger or smaller:

*Has your pet experienced any lameness, limping, or difficulty rising?

Yes No

If yes, please explain

*Does your pet have bad breath?

Yes No

Anything else we need to know or check?

Submit Your Message:

Hours of Operation

Monday-Friday

7am-5:30pm

Saturday

8am-12pm

Closed Sunday

Pet Care Professionals
2651 Union Avenue Extended
Memphis, TN 38112
ph: 901-324-0202
fax: 901-324-3333
pcp_vets@bellsouth.net