New Puppy Form

Welcome to Taylor Veterinary Practice. Congratulations on your new arrival! To help us get to know you and your pet better, please answer these questions before your appointment.

Select a surgery

About You

Title

First Name

Surname

Address

Phone Number

Work Number (optional)

Email Address

Is this your first pet of this kind?

Do we currently treat or have we treated any of your pets in the past?

Yes
No

If Yes, please tell us their name(s)?

Could they be registered under a previous name or address? (If so, please list below)

About Your Pet

Pet Name

Pet Species

Please specify

Breed

Age

Date of Birth (if known)

How long have they lived with you?

Do you have any insurance for them?

Yes
No

If Yes, which company?

If No, would you be interested in 4 weeks free insurance with Pet Plan?

Yes
No

Where did you get your new arrival?

Have they been Microchipped?

If Yes, what is their microchip number?

Is the microchip registered to you?

Yes
No

Have they had any Vaccinations?

If Yes, on what date, and with what vaccine?

(Please bring your vaccination card to your first appointment)

Have they had any worm or flea treatment?

If Yes, which brand and on what date?

What do you feed them? (Brand/How often/How much)

How would you describe their faeces

Runny
Soft
Firm
Hard

Have you seen any worms or blood in it?

Have they been sick since they arrived home?

Yes
No

Do they cough or sneeze?

Yes
No

If Yes, how often and do they bring anything up?

Have you noticed them having sticky eyes?

Yes
No

If Yes, what colour was the discharge?

Clear
Yellow
Green
Other

Have you noticed them persistently scratching anywhere?

Yes
No

If Yes, where do they scratch?

How often do they scratch in a day?

Do you know if Mum and/or Dad had any health screenings? (e.g. Hip Score, Elbow Score, Eye Testing)

Do you have any concerns about your pet?

Do you have any questions you would like to ask us about your pet?

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