Veterinary Clinic Checklist Form

Veterinary Clinic Checklist Form

Please complete this checklist to ensure all necessary procedures and tasks are performed for your pet’s visit.

Client Information

Name

    Phone number

      Email

        Pet’s Name

          Pet’s Age

            Medical History

            Has your pet been vaccinated recently?

            Any recent health concerns?

            If yes, please specify

              Physical Exam

              Weight

                Temperature

                  Heart Rate

                    Respiratory Rate

                      Eyes

                        • Normal

                        • Abnormal

                        Ears

                          • Normal

                          • Abnormal

                          Teeth/Gums

                            • Normal

                            • Abnormal

                            Vaccinations & Treatments

                            Rabies Vaccination

                              • Up to date

                              • Not up to date

                              Flea & Tick Treatment

                                • Given

                                • Not Given

                                Deworming

                                  • Given

                                  • Not Given

                                  Other Treatments

                                    Additional Notes

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