New Pet Patient Intake
The vet's first-visit fact-find: history, diet, behaviour notes, and prior records.
6 questions · 1 page · about 4 minutes to answer · fully editable after you start
First veterinary visits start best with the history already in hand: the pet's background, current diet and medications, behaviour notes that keep staff safe, and previous-vet records requested before the appointment. This intake collects it from the owner at booking time.
The behaviour question is a kindness to everyone: knowing a dog needs slow introductions or a cat panics in carriers changes how the team prepares, and visits go better for it.
Template preview
This is a picture of every question as a respondent would see it, so nothing on it can be clicked or typed into. Use this template to get your own editable copy.
Opens in the Light theme, or in your own default theme if you have set one — change it anytime to any of the 4 built-in looks, or build your own on a paid plan.
Page 1
About your pet
Welcome. This form tells us about you and your pet, so we have the history we need before your first visit. It takes about 4 minutes.
Q1.Pet's name, species, breed, and age*
Q2.Owner's details*
Q3.Current diet, medications, and supplements (write None if none)*
Q4.Known conditions, past surgeries, or ongoing issues*
Q5.How does your pet usually handle vet visits?*
- Calm
- Nervous but manageable
- Very fearful
- Can be reactive - handle with care
Q6.Previous vet practice (so we can request records)
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