Medical Progress Appointment Questionnaire Pet NameClient NameDate MM slash DD slash YYYY Reason for visit:1. How do you feel your pet is doing since their visit with us?2. What medications and/or supplements is your pet currently taking?3. Do you have any questions or concerns with your pet that you would like us to address at your visit today?Client questions:1. Have you or anyone in your household been exposed to Covid-19 within the past 10 days? Yes No If so, when?2. Have you or anyone in your household had any respiratory illness within the past 10 days?3. What is the best phone number to reach you at?Which type of appointment would you prefer? Curbside (wait in your vehicle while our team provides care) In Person Appointment (accompany your pet into the examination room) Outdoor Gazebo
