General:

What is your pet's current problem? When did it start?

When was your pet last normal?

Is your pet indoors only? If not, please describe outdoor access

What is your pet's travel history? Exposure to other animals?

When was your pet last vaccinated and what vaccines were given?

Current medications / supplements?

Has he/she had them today? if so at what time were they given?

Are there any known allergies to any medications?

Eating & Drinking:

Has your pet's appetite changed recently? How long ago?

Has there been any weight loss that you are aware of?

What does your pet normally eat? (Include brand of food, wet/dry/combo, and amount fed and frequency

Any treats or human food? Food allergies?

Normally is your pet a picky eater? Robust? Eats everything?

Have you noticed that your pet's water intake has changed recently? Increased/Decreased?

Is your pet known to try to eat things it is not supposed to?

Elimination:

Does your pet have diarrhea? If so, what is the consistency, color, and frequency of the stool?

Is there any straining during defecation?

Has your pet been vomiting? If so, what is the frequency and consistency (clear fluid, bile, food, etc)? Last time?

Is there abdominal effort when producing vomit or does it come up passively?

When did the vomiting and/or diarrhea start? (Please be specific)

Coughing or Sneezing?

Is your pet urinating normally? Does he/she have a steady stream? Does he/she urinate small frequent amounts frequently? Any straining during urination? Dribbling?

Gait:

Is your pet walking normally? Is it limping? Which leg(s) is affected?

Is your pet "bunny-hopping"?

is there a known injury or accident?

Neurological

Does your pet have a history of seizure activity? If so, when?

Is your pet painful when handled or touched?

Anything else we should know?

In order to help your pet faster, diagnostics and/or treatment may be recommended before a phone conversation. In this event:

Do we have permission to perform diagnostics (cytology, bloodwork, x-rays, etc.) for your pet?

I agree

Do we have permission to begin treatment for your pet?