Canine Health Survey

TRAVEL AND OUTDOORS
Do you take your dog to any of the following?
Do you travel with your dog?
Do you take your dog hiking, hunting, camping, or fishing?
HOME ENVIRONMENT AND HOME CARE
Do you observe wild animals or other wildlife in your neighborhood?
Do you or your dog visit homes where there are pets?
Do other pets come to visit at your house?
Do children, elders, or people with weakened immune systems live in or visit your home?
Have you seen fleas or ticks on ANY of your pets in your home?
Have you seen worms in your dog’s poop or on their back end?
Which pets do you treat for fleas, ticks, internal parasites, or heartworms?
How often do you treat your pets for fleas, ticks, internal parasites or heartworm?

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

What kind of food do you feed your dog?
Do you feed your dog treats?
Do you brush your dog’s teeth?
Has your dog had their teeth scaled while awake?
UNUSUAL BEHAVIOR
Does your dog scratch, bite at their skin, or seem “itchy”?
Does the sound of your dog’s clanking tags wake you up at night?
Any weight loss or gain?
Any change in your dog’s skin or hair coat?
Any recent change in your dog’s behavior?
Any recent change in your dog’s activity level?
Any signs of pain?
Any signs of tremor or weakness in the rear legs?
Any recent changes in your dog’s behavior when defecating or urinating?
Any recent changes in your dog’s behavior toward you, other family members, other pets, or strangers?
Has your dog seemed “grumpy”, or started to shy away from physical touch and petting?