Codornices Veterinary Clinic
Wellness Exam Questionnaire
How would you like to be contacted
What Brand/Flavor of food does your pet eat?
Is you pet eating and drinking well?
What heartworm/flea/tick protection is your pet currently taking?
Is your pet urinating and defecating normally?
Is your pet coughing or sneezing?
Have you notice any stiffness or soreness when you pet is moving around?
Please list all the medication that your pet is currently taking. Please list dosages if possible.
Is there anything else you would like us to know?
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