Canine Lifestyle
Survey Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

Canine Lifestyle Survey Form

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Client's Name
Approximately what percentage of time does your dog spend outside?
I travel with my dog to (select all that apply)
I take my dog to the following (select all that apply)
I give my dog heartgard plus or another monthly heartworm and intestinal parasite preventive
I give my dog frontline plus, nexgard, or another monthly flea and tick preventive
I have the following other pets in my home