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Annual Wellness Exam - Canine
Owner Info
Name
First
Last
Email
Would you like more information on ways to connect with us, access your pet’s medical records, and order medication/products?
Yes
No
What would you like more information on
Our Online Shopping Store (MyVetStore)
Our Mobile App
Pet Insurance
Send information on everything
Would you like 4 free weeks of pet insurance? (No obligations or purchase necessary)
Yes
No
Pet Info
Name
On a normal day, what does your dog eat (Brand/amount)? How often? Example: twice daily, free fed. Please include any treats or people food.
Does your dog board?
No
Yes
Occasionally
Which Boarding Kennel do you bring your dog to?
Do you bring your dog to the off leash dog park, dog classes, doggy daycare?
No
Yes
Do you travel with your dog outside of the North Bay Area?
No
Yes
Where do you travel to?
Is your pet currently on parasite prevention; example: Revolution, Simparica, Interceptor Plus?
No
Yes
When was the last dose given?
Date Format: MM slash DD slash YYYY
Parasite Screening
Our doctors are recommending annual parasite screening for all adult dogs as part of their annual wellness exams. This is to ensure your pet is parasite free as most infestations are not symptomatic and not all parasite preventatives cover the wide range of parasites that our pets can pick up. We have found that when we are testing fecal samples, we sometimes find parasites that need to be addressed. We ask that you bring a sample of your pet’s feces so we can ensure your pet is parasite free. Would you like a reminder through our app to bring a fecal sample for your appointment?
No
Yes
Is your dog over the age of 7?
No
Yes
Is there anything specific you would like your pet's medical team to discuss, address concerns about, or provide additional information on?
Would you like more information on wellness screening?
If your pet is over the age of 7 our doctors are recommending screening tests. Running these tests help us understand what’s normal for your pet as well as screen for common conditions. Subtle changes in your pet’s test results can signal the presence of disease even before any outward signs of illness can be seen. It would consist of running a blood sample from your pet that can be taken while they are here for their wellness exam.
No
Yes
Great! Our technician will follow-up with more information and pricing.
Medical Appointment
Do you have any specific concerns you would like addressed with the doctor?
No
Yes
Please explain
Do you need to pick up any medications, food, or products at your visit?
No
Yes
Please let us know what you need as there may be delays if we need to order it in
Would you like any additional information on a specific topic (behavior issues, medical issues, parasite prevention or product)?
No
Yes
Please let us know what information you would like and our technician will follow-up with you.
Has your pet had any problems with his or her current food?
No
Yes
Does your pet have lameness?
No
Yes
Does your pet have a lump or wound?
No
Yes
Any additional details or concerns that you would like addressed?
If an opportunity becomes available do we have permission to take a picture of your pet and post to our social media platforms? Only your pet’s first name will be used.
No
Yes
Do you have any specific questions and/or concerns you would like addressed?
We are implementing a new program called CoVet. This innovative tool will help us maintain up-to-date and thorough medical records for your beloved pets. What this means is that your visit with us will be recorded through this program and used to update our medical records. The primary aim of using CoVet is to ensure that we provide the best possible care through accurate and comprehensive medical records. Rest assured that all discussions and information recorded during the visit are kept strictly confidential. Do you give permission for us to use this tool during your visit?
Yes
No
Thank you for trusting us with your pet's health
Do you plan on travelling to the United States in the next 30 days?
Yes
No
Please click on the link for more information as the CDC has updated their requirements. https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/dogs.html
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About Us
Join Our Team
Location & Hours
Meet Our Team
History of Shannondale Farm
What’s happening at Shannondale
Memorials
Forms
Links
Clients
Take A Tour
Pet Insurance
Survey Form
Request an Appointment
Services
Dental Healthcare
Euthanasia and Aftercare
How do I setup the appointment?
What happens during the appointment?
What actually happens when my pet is put to sleep?
Will the procedure be painful for my pet?
What are my options for aftercare?
I am having a difficult time grieving my loss. What support resources are there?
Anesthesia and Patient Monitoring
Medical Services
Preventive Services
Surgical Services
Wellness and Vaccination Programs
Additional Services
Emergency Information
Pet Health
Educational Articles
How-To Videos
Pet Health Checker
News
Pet Portal
Contact Us
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