Pet's Medical Information and History

Please complete this form before your visit.

Owner's Name *

First

Last

Phone *

Email *

Pet's Name *

My pet is in: *

Boarding
Daycare
Grooming

Primary Veterinarian (if not Erlanger Veterinary Hospital)

Do you have any other pets? *

If yes, please list *

Reason for today's visit *

Has your pet had any recent medical problems? *

If yes, please describe *

Does your pet have any long-term medical problems? *

If yes, please describe *

Does your pet have any allergies? *

If yes, please describe *

What is your pet's diet (brand name)? *

How much/often are you feeding? *

Is your pet currently taking any medications? *

If yes, please list drug name and current dosing *

Please select the signs/symptoms your pet has shown recently, if any

Coughing
Sneezing
Wheezing
Gagging
Excessive panting
Squinting
Itching
Hair loss
Poor hair coat
Shaking head
Scratching ears
Vomiting
Diarrhea
Scooting
Excessive licking
Lumps/bumps
Limping
Stiffness
Listless
Seizures/tremors
Bad breath

Please describe *

Has your pet shown a significant change in any of the following:

Character of bowel movements
Appetite
Drinking
Frequency or amount of urination
Weight gain or loss
Behavior

Has it gotten better or worse? *

Better
Worse

Has it gotten better or worse? *

Better
Worse

More or less? *

More
Less

More or less? *

More
Less

More or less? *

More
Less

More or less? *

More
Less

Any questions for the veterinarian?

If due, would you like an intestinal parasite (fecal) on your pet to check for intestinal parasites? (required ANNUALLY for daycare) *

If due, would you like an occult heartworm test (blood) on your dog to check for heartworm disease and tick-borne disease? *

Yes
No
My pet is not a dog

For pets under 6 years of age, we recommend an annual lab profile, which checks liver and kidney functions, blood cell count, and includes an intestinal parasite exam and an occult heartworm test on dogs or a FeLV/FIV test on cats. *

Yes
No
My pet is over 6 years of age

For pets over 6 years of age, we recommend a senior lab profile. This will check liver and kidney functions, blood cells, thyroid level, and urine to identify illness early and treat before they become major problems. An occult heartworm test is included for dogs or a blood pressure test for cats. *

Yes
No
My pet is under 6 years of age

We recommend year-round use to prevent heartworm disease in dogs and cats and to prevent flea infestation. Would you like to purchase a refill of heartworm and/or flea and tick medications? *

Brands carried: Interceptor+, Sentinel, Simparica, Bravecto, Revolution+.

Annual heartworm test is required for dogs to refill heartworm prevention.

Revolution is only offered for cats.

How many doses would you like? *

Contact Erlanger Pet Resort today!

We are happy to be your pet’s home away from home, and the place they feel comfortable getting pampered.

Our Address

3404 Dixie Hwy
Erlanger, KY 41018
Click here for directions.

Our Hours

Mon - Sun: 8:00 am - 4:00 pm

Boarding: Mon-Sun / 6:00 am - 8:00 pm

Daycare: Mon, Tue, Thu, Fri / 7:00 am - 5:00 pm

Grooming: Mon-Sun / by appointment

Contact Us

Call: 859-727-3940
Fax: 859-342-2255
Email: erlangerpetresortandspa@gmail.com