"*" indicates required fields Pet's Name*Species* Canine Feline Lagamorph Chinchilla Guinea Pig Ferret Reptile Other Breed*Color*Sex* Male Female Altered Yes No Age*Age* Weeks Months Years Did you recently acquire your pet? Yes No Where did you get your pet?*BreederFriend / FamilyStrayHuntsville Animal ServicesHumane SocietyRescueOtherWhat is your pet's vaccination status?*Current vaccinationsNeeds vaccination updatesHas never had vaccinationsNot sureDoes your pet receive heartworm, flea, and tick prevention? Yes No What product(s) do you use for heartworm, flea, and tick prevention?*How often do you use these products?*Does your pet have any pre-existing medical conditions? Yes No Please list medical conditions.Is your pet currently taking any medications or supplements? Yes No Please list medications and supplements and include dosing instructions.Do you need any refills? Yes No Which medications or supplements do you need to be refilled at your visit?Does your pet have any food allergies or sensitivities we need to be aware of? Yes No We may use treats to make your pet's visit more enjoyable.Please list any known allergies.Where are your pet's records located?*Please Select...My previous veterinarianI have a copyMy pet has never been to the veterinarianPlease upload a copy of your pet's records.Max. file size: 256 MB.May we contact your previous veterinarian?* Yes No What is the name and/or phone number of your previous veterinarian?NameThis field is for validation purposes and should be left unchanged.
