senior pet questionnaire Please click the button below to fill out the form. Get Started 7 Senior Pet Questionnaire Please fill out the form as completely and as accurately as possible, thank you. Please enable JavaScript in your browser to complete this form.Client Name *FirstLastEmail *Pet's Name *FirstLastPet's Age Selected Value: 0 Check the box if your pet experiences any of the following:Difficulty climbing stairsSkin or hair coat changesDifficulty jumping upLumps or bumpsIncreased stiffness or limpingExcessive scratchingLoss of housetrainingChanges in sleep pattersIncreased thirstLess enthusiastic greetingsIncreased urinationIncreased appetiteChanges in activity levelDecreased appetiteVomitingOther changes in breathing patternChange in stoolsCoughingProblems defecating/strainingCircling or repetitive movementsWeight lossConfusion or disorientationWeight gainExcessive barking/vocalizationDifficulty hearingLess interaction with familyVision problemsDecreased responsivenessBad breathIf yes to any of the above, please explain *Submit
