Standard Pre-Appointment Questionnaire

Name: Beaverton Pet Clinic
Address: 11876 SW Beaverton Hillsdale Hwy, Beaverton, OR, 97005, United States
Telephone: 503-646-6101

We have reopened and are excited to welcome you back into the hospital! Please review the following to ensure a smooth and timely appointment:

A pre-visit questionnaire is required for all appointments, please complete the questionnaire below in advance to prevent a delay to your appointment check-in.
If your pet requires pre-visit sedative medication, please give at the appropriate time as directed by your veterinarian. If you need a refill or have forgotten to administer your pet’s medication please call us ASAP at 503-646-6101. Arriving without administering the required medication will result in significant delays or rescheduling.
Upon arrival please come into the lobby with your pet safely secured. Cats must be in a carrier and dogs must be leashed or in a crate.

Name *

First

Last

Name of person attending appointment *

First

Last

Phone number of person attending appointment *

Email *

Pet's Name *

Appt Date & Time *

Date

Time

Has your pet had exposure to any person with either COVID-19 symptoms or a confirmed positive test within the last 2 weeks? *

If yes, please contact Frontier immediately to discuss the best option for getting your pet's care safely.

What kind of food are you feeding and how much/frequency? *

What medications/supplements is your pet on? Do you need any refills? *

Is your pet on parasite control? Brand/last applied? *

Lifestyle: Indoor/outdoor? Daycare? Travel History? *

Any coughing, sneezing, vomiting, diarrhea? *

Previous vaccine reactions? *

Concerns for today? Please be specific with details (i.e. the length of time a problem has been occurring, where a mass is located/how long it has been present, which leg is affected by limping, etc.)

Name