Online Questionnaire

Online Questionnaire

Online Questionnaire

At Desert Veterinary Clinic, we offer patient forms online so you can complete them in the convenience of your own home or office. You may email us the completed forms or bring them with you on your next visit.
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  • If you do not already have AdobeReader® installed on your computer, Click Here to download.

  • Download the necessary form(s), print it out and fill in the required information.

Patient Name:

Client Name:

What is your appointment date/time:

Is your pet spayed or neutered?

If not spayed, when was the last heat cycle and approximately how long did it last?

Are all vaccinations current?

If not current, would you like them updated today?

Is your pet eating and drinking normally?

What kind of food does your pet eat?

Is your pet offered table food?

Is your pet strictly indoor/ outdoor?

Does your pet travel often or have they recently traveled to an area outside of Yuma? If so, to where?

Does your pet visit a groomer or boarding facility?

Does your pet have any coughing, sneezing, vomiting or diarrhea?

Any medications or OTC supplements your pet is taking?

Is your pet currently on heartworm prevention?

Has you are anyone one in your household been exposed to or are currently having symptoms of Covid 19 now or within the last 2 weeks?

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