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GCVS Referral Portal
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Surgery & Orthopedics Patient History
What symptoms have you observed at home?*
How long have the symptoms been present?*
Did the symptoms start suddenly?
Are the symptoms:
Staying the same
Is your pet otherwise normal?*
Are there other medical problems we need to know about?
Has your pet had any previous surgery other than spay or neuter?*
Is your pet on any medication?*
What medication(s) has your pet taken for this problem in the past?
If medications are being used to treat the condition for which we are evalutating your pet, have they been associated with any improvement in the condition?
Have medications been previously used that were NOT successful?
Please list ALL medications your pet currently taken for UNRELATED problems
Did you bring any radiographs or lab test results?*
Did you bring any Medical Records?
What kind of food do you feed your pet?*
What types of snacks/treats do you feed your pet and how often?*
Do you have other pets?: