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Appointments at The Bluffs Pet Clinic in Red Wing, MN
Emergency

2518 Old West Main,
Red Wing, MN 55066

(651) 388-1103

The Bluffs Pet Clinic

CHINESE MEDICINE HISTORY

*Please type on the line to submit the form

Date:
Owner’s Name:
Pet’s Name:

Where does your pet like to spend most of their day?

Where do they sleep? (i.e. on hard surfaces, carpeted surfaces or furniture)

How often are they at the water bowl?

Do they drink a lot at one time when there?

What does their urine look like?

How are their bowel movements?

How many do they have a day?Any straining?

Do they seem painful anywhere?

Do they feel better with massage? Heat? Cold?

How do they act when people come to the door? (i.e. bark? greet people? submissive urination? run and hide? get excited? etc.)

Do they prefer warmer or cooler areas in the house? ( i.e. lay be the heat registers, in the sun, on the cold tile floor, by drafts?)

Do they prefer warm or cold seasons?

How is their appetite?

What kind of food do they eat? Any table scraps?

What brand of food/treats do you feed your pet? How much food do you feed per day? How many meals?

Do they eat breakfast well or at all?

What time do they get up in the morning? Would they like to sleep later if you did?

Do they try to get you up in the morning?

When do they like to go to bed?

How is their breathing? ( i.e. problems with breathing, panting?)

Does your pet vomit? When, how often and what does it look like?

Any coughing? If so, when does it occur? What does it sound like? (loud or soft, wet, dry hacking etc.)

Any sneezing? How often does it occur?

Any nasal discharge? If so, what does it look like? How often does it occur?

If your pet were a person, what kind of person would they be? (i.e. quiet, care taking, bossy, energetic, lethargic, couch potato, hard worker, easy going, rule enforcer, general or director, leader or follower)

Does your pet like exercise? Play?

Do they adapt well to change or seem stressed by it?

How do you feel your pet's energy level is?

Do you have any other concerns that we should know about?

Please list any medications and/or supplements that your pet is taking:

What is your goal in pursuing Alternative Medicine therapies for your pet?

The Bluffs Pet Clinic



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Quick Links

The Bluffs Pet Clinic

2518 Old West Main, Red Wing, MN 55066

(651) 388-1103

Hospital Affiliations:

American Animal Hospital Association American Veterinary Medical Association Go to the American Association of Feline Practioners Go to Care Credit Go to the American Academy of Veterinary Acupuncture Go to Minnesota Veterinary Medical Association Go to the American Holistic Veterinary Medical Association Go to the Pet Poison Helpline Go to Trupanion insurance

The Bluffs Pet Clinic © 2017
2518 Old West Main, Red Wing, MN 55066
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