Patient Update – IntVetCare.com

IVC Patient Update

"*" indicates required fields

So that Dr. Kangas may best prepare for your consultation, please complete and submit the information below. Notes: All questions require a response, if the answer is no or none, please simply type NONE or N/A in the prompt. Average time to complete is 3-5 minutes. Please be sure to have a photo of your pet available to upload.

Your Name*

First Last

Spouse/Partner/Significant Other (that you would like on record)

Address

if your address has changed recently, please update

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Phone*

Your Email*

Your Pet's Name*

Chief concerns or reason for appointment*

Describe concerns/reason for scheduling this appointment

What is your pet's current diet?*

Please include brand of food, amount being fed and frequency of feeding

Please list all prescribed medications and their related doses that your pet currently take*

please include heartworm and/or flea/tick prevention

Please list all supplements and their related doses that your pet currently take*

include brand, amount given and frequency

If your pet has been seen by your primary care vet, specialist or emergency clinic since your last appointment with Dr. Kangas, please provide the name of the clinic and phone number so we may reach out for records*

if you prefer, you may send records directly to records@intvetcare.com

When and where was bloodwork or other testing last performed? (including Microbiome, Allergy, Hair Mineral Analysis, Nutrient, etc)*

please provide approx date of what was performed along with name and phone number of clinic where it was done

Has your pet received any vaccines since your last appointment with IVC?*

if yes, please list vaccine and date given

Has there been any major changes in the pet's household environment (moving, marriage, death of other pet or human, divorce, new pet)?*

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Entry Date*

IVC Patient Update

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