Thorpe Animal Hospital

1678 Mayfield Rd
Lapeer, MI 48446

(810)664-2233

www.thorpevet.com

Pre-Visit Client Questionnaire

Name
First Name
Last Name
Client Name

Date :
How would you describe your pet's reaction to the going to the veterinary hospital?
Eager and Excited
Subdued
Reluctant
Somewhere in between
Check any situations below that your pet has shown avoidance or dislike of in the past. You can add comments at the end
Getting in the carrier or car
Entering the veterinary hospital
Others pets and/or people passing by while in reception/check-in
Waiting with other people and animals in the waiting room
Being approached by veterinary staff
Getting on the scale for a weight
Hearing the doorbell, overheard intercom, or phones ringing
Sounds coming from the back areas of the practice
Going into the exam room
Being put up on the table for examination
Having direct eye contact with the technician and/or veterinarian
Loud voices during examination
Having a rectal temperature taken
The use of instruments such as the stethoscope or otoscope
Being taken out of the exam room for procedures
How and where does your pet travel in the car?

How does your pet behave in the car?

Does your pet show any signs of nausea with car travel, such as drooling or vomiting?

How would you describe your pet around other animals and people?

Does your pet have any sensitive areas that he/she does not like to have touched or examined by you or others?

Are there are procedures your pet has not liked having performed at the veterinary hospital in the past or that seemed difficult for you or the staff to do? (nail trims, weight, temperature, blood draw). If so, how did your pet react?

What are your pet's favorite treats? (Please bring some with you)

Does your pet like to play with toys? What kinds?

Has your pet ever been prescribed any medications to help with a visit to the veterinary hospital? If so, please list below.

Anything else you would like us to know?


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