Pet Profile | Birchmount Veterinary Clinic

Gerneral Information

Date

Pet's Name

Breed

Colour

Sex

Age

Name

FirstLast

How long have you owned your dog?

Where did you get your dog?

If adopted, do you have any knowledge of yuor dogs past history?

Are there children in the household?

Yes
No

If yes, what are their ages?

Are there any other animals in your household? Please list.

How does your dog get along with other resident animals?

Health

Does your dog have any old or current injuries or health concerns? Please describe.

Does your dog have hip dysplasia? If yes, what restrictions need to be placed on your dog's activities or movements?

Does your dog have any sensitive areas on his/her body? If yes please describe.

Has your dog had fleas within the past 3 months? If yes please describe treatment used.

Please note: All dogs must be on Revolution or Advantage, over the counter flea prevention is not an acceptable alternative.

Behaviour

Has your dog ever bitten someone? What were the circumstances?

Has your dog ever growled at someone? What were the circumstances?

Has your dog jumped at/on someone? What were the circumstances?

Has your dog ever bitten another dog? What were the circumstances?

Do any visitors bring their dog(s) to your house? If yes, how does your dog react?

Does your dog bark or growl at anyone passing outside your house or yard?

Yes
No

How does your dog react to a stranger coming into your home or yard?

Are there any types of dogs your dog automatically fears or dislikes? If yes, please list.

How does your dog react to puppies?

How does your dog how he/she is happy?

How does your dog show he/she is annoyed?

How does your dog react to another dog approaching on a walk or at the park, on leash and off leash?

Has your dog ever shared his/her food with other animals?

Yes
No

Has your dog ever shared his/her toys with other animals?

Yes
No

Does your dog play with other dogs? If yes what kind of dogs and where.

Does your dog play with any toys? If yes, what kind of toys and games does he/she enjoy?

Does your dog prefer to play withmale or female dogs?

Male
Female
Both

Is your dog frightened by any noises? If yes, please describe.

Is your dog frightened or nervous around anything else? If yes please describe.

Has your dog ever climbed a fence?

Yes
No

Does your dog have a bathroom command?

Does your dog have any play commands?

Does your dog have a settle/quiet command?

Does your dog eat stool?

Yes
No