Canine Health Survey

TRAVEL AND OUTDOORS

• Dog parks
• Doggie day care
• Boarding or grooming facilities
• Puppy school
• Obedience training
• Organized competitions

• Yes
• No

• Yes
• No

HOME ENVIRONMENT AND HOME CARE

• Feral cats
• Squirrels, chipmunks, skunks, or small rodents
• Raccoons
• Deer
• Wild turkeys
• Wild canines (coyotes, foxes)
• Other

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Dog(s)
• Cat(s)

• Seasonal
• Year-round
• When I remember
• Other

Please list all products, medications, or supplements your dog is using.

• Dry
• Canned
• Raw
• Homemade

• Yes
• No

• Yes
• No

• Yes
• No

UNUSUAL BEHAVIOR

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No

• Yes
• No