Facebook Instagram
Call for Appointment

Pet Rehabilitation Assessment

We look forward to helping you and your pet with integrative veterinary care. Please complete the Rehabilitation Assessment Form below.

Pet Rehabilitation Assessment
Name
Name
First
Last
Please tell us your preference for treatment of your pet(s)
How much information do you want to be given about your pet's visit?
Is your pet food motivated?
Are there other pets in the house?
Do all your pets get along or are there conflicts?
Is your pet aggressive towards:
Check all that apply
Have there been any significant medical issues in the past (i.e. surgeries, accidents, vaccine reactions, noise phobias (e.g. vacuum), separation anxiety, etc.)?
Has there been any signs of:
Any changes in attitude/temperament?
What time of the day (if any) do you notice discomfort, stiffness or soreness in your pet:
Have there been any changes in the household recently?

 

Functional Abilities

Ability to position to urinate and defecate
Able to change position from lying and sitting or vice versa
Ability to change position from sitting and standing or vice versa
Able to lay on his/her side and then change position
Able to scratch behind ears
Able to stretch while standing or laying
Able to negotiate the flooring throughout the home
Able to get in and out of the home
Able to get on/off the couch or bed
Able to get in/out of the car
Able to go up stairs
Able to go down stairs
Able to run
Able to jump
Able to stand while eating
Please indicate where you are noticing lameness or soreness or where lumps/masses are present on your pet.
Facebook Instagram