New Patient Form

The following New Patient Form is for clients/ patients that have a confirmed initial consultation with one of our veterinarians.

If you have not yet scheduled a consultation, but would like to make an appointment, please call our front desk at 206-773-2262 or email us at svrc@soundvetrehab.com​.

If you have a confirmed consultation, please complete and submit the New Patient Form below. This form must be completed and returned to us no later than 48 hours prior to your appointment or your appointment will be canceled and given to the next person on our wait list.

NOTE: If you don’t see this Thank You page after submitting your form, please check for errors as your form was not submitted correctly.

Client Information

Patient Information

Has your pet gained or lost weight in the last 12 months?

Medication, Diet & Allergies

Include all supplements, parasite prevention, over the counter and prescriptions. Please also include frequency of administration and date of last dose(s).

Allergies to any medication (vomiting, diarrhea, change in appetite, sedation, etc.). Please list medication and reaction.

Please list all sources of calories your pet takes in – dog/cat AND people food. Include pet food brand, formulation (dry, can, raw), amount, frequency (once a day, free choice, twice a day) and ALL treats and table scraps.

Please list any clergies your pet has to foods.

Current Complaint

What is the presenting complaint? (provide as much detail as possible).

How long has this been going on?

What is the state of your pets condition?

Was there a history of trauma or inciting cause?

Are there situations that make this complaint better or worse? (ie - is your pet more sore first thing in the morning but then warms out of it? Does he/she become lame after a long walk or play?

Have you tried any medication or therapy for this complaint? Did it help?

What is your pet’s current exercise and activity level? Include frequency and duration of walks, dog park, hiking, swimming, etc.

Have you noticed any of the following? (check all that apply).

Previous Medical and Orthopedic History

Where has your dog traveled in the last 3 years? (Eastern WA, Oregon, Florida...).

List all surgeries, including spay or neuter, and approximate date.

List any previous medical history, including any hospitalization or treatments (ie, seizures, bladder infection, pancreatitis).

Goals and Expectations

What is your ideal level of exercise or activity for your pet? (ie, able to play at the dog park without being sore, able to go for a walk without limping, able to hunt or participate in agility competitions).

Describe any other goals or concerns regarding pain management and mobility that you would like to discuss.

Acknowledgment

Please check all that apply.

We often take pictures of our rehab patients and post stories on our website and social media. Do you authorize use of pictures of your pet for this purpose only? Be sure to follow us on Facebook!

Thank you. We'll be in touch regarding your pet's health.

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