Canine Lifestyle Review CANINE LIFESTYLE REVIEW Owner's Name Pet’s Name Date It is our goal to provide you with the up-to-date information you need to make informed decisions about your pet’s health care needs. My dog spends most time IndoorsOutdoorsIn and Out My dog comes in contact with other pets… While boarded at a kennelWhile professionally groomedWhile at dog parkMy dog does not come in contact with other petsOther Please specify? What do you feed your dog? If offered table food, list examples Which best describes your dog’s weight? Too ThinNormal WeightGained a few poundsNeeds to lose weight Which best describes your dog’s breath? Not badUnpleasantReally bad Are you interested in annual bloodwork? YesNo Which best describes your dog’s water consumption? Same as last yearMore than last year Please check any conditions that your pet has experienced? Crying in painEye dischargeHair lossNew or enlarged growthsSneezingChange in appetiteChange in behaviorVision problemsFleas or ticksFrequent urinationOdor from ears Is your dog receiving medication other than in the ones dispensed from this hospital? YesNo Please list Is your dog currently using flea and heartworm prevention? YesNo Please list Do you need any refills?