LAKESIDE VETERINARY CLINIC

PET'S PERSONAL HABITS QUESTIONNAIRE

Pet's Name/Nickname: _______________________________________________________

Pick Up Date: ___________________________ Time: _____________________________

1. Did you bring your own food? Yes No

2. Did you bring your own treats? Yes No

3. How frequently do you feed your pet? ______________________________________________

4. How much do you feed your pet? __________________________________________________

________________________________________________________________________________

5. Did you bring medications? Yes No

6. Is your pet afraid of other dogs/cats? Yes No

7. Is your pet aggressive toward other dogs/cats? Yes No

8. Will you be leaving your leash here? Yes No

If yes, please describe your leash: __________________________________________________

9. Do you have a blanket or toy? Yes No

If yes, please describe your blanket and/or toy:________________________________________

_______________________________________________________________________________

Thank you for your time. We will do everything to make you pet's stay pleasant and like home.