Senior Clinic Questionnaire


Dogs Only

Has your dog slowed down on walks recently?:

Do you now have to help your dog up, or into/out of the car?:

Does your dog have red/weepy eyes often?:

Has your dog shown signs of confusion/disorientation?:

Cats Only

Has your cat stopped jumping onto/off surfaces or going up/down stairs?:

Dogs and cats

Has your pet's appetite changed?:

Has your pet's thirst changed?:

Is your pet urinating more?:

Has your pet gained or lost weight?:

Has your pet's hair coat changed?:

Do you think your pet has trouble seeing?:

Security Question: