Please note: We will be closed from Saturday, December 24th through Monday, December 26th in observance of Christmas!

Behavior Recheck Questionnaire

Please fill out this questionnaire as completely as possible. If you have any questions or need clarification on any of the choices, please contact us. As always, thank you for entrusting us with your pet’s care!

Please list your pet’s current issues and indicate whether they are pre-existing or new since your last visit. For pre-existing issues, please note what changes there have been. Pre-existing issues-for each problem, rank the change in intensity and frequency according to the following scale:
Intensity:
1. Worse
2. <25% Improvement
3. 25-50% Improvement
4. 50-75% Improvement
5. >75% Improvement

Frequency:
1. Worse
2. <25% Improvement
3. 25-50% Improvement
4. 50-75% Improvement
5. >75% Improvement