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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

Standard Medicine History

*Please type on the line to submit the form

First Name:
Last Name:
Pet’s Name:

What is the primary reason you scheduled this appointment?

What brand of food does your pet eat?

How much are you feeding them?

Do they get treats or tablescraps?

Has there been any change in their activity level?

What product are you using for Flea and Tick protection?

What product are you using for Heartworm protection?

Will you need any refills of medication while here for your appointment?

Has your pet experienced any of the following in the last 30 days? Please check all that apply.

Vomiting                                             Diarrhea
Coughing                                             Sneezing
Inappropriate urination/defecation      Lumps
Limping                                               Itching
Eye redness/discharge/irritation          Smelly/itchy ears
Pain/Discomfort                                  Other

If you answered yes to any of the above, please explain in further detail on this form what you are noticing (i.e when did it first start? Is it getting better, worse, or staying the same?)

Do you have any additional concerns that you would like addressed during your pet’s appointment?


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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