Connect Patient Update

Please fill out the following patient update form to receive further medical advice. Fill out the mandatory sections and applicable sections to your pet’s current condition. If your inquiry is urgent, please call the clinic at (403) 370-8800 and a team member will help you and your pet.

    Owner and Patient Information

    Last Name*

    First Name*

    Phone Number*

    Email*

    Pet Name*

    Update Information

    Nurse*

    Date of Last Recheck*

    Reason for update to the Nurse*

    Medications

    Medication

    Dose

    Frequency

    Have you seen any side effects due to Medication?*

    Habits and Diet

    Current Diet*

    Current Treats*

    What is your pet's current itch score?

    Moderate Itching (Frequent Episodes):
    My dog is itching occasionally throughout the day but is not itching while eating playing, sleeping or whie being distracted. Itching ensues at night when observed.

    How is your pet doing?*

    What are your pet's bowel movements like?*

    What is the size of your pet's bowel movements?*

    Frequency/number per day?*

    Additional Information

    Bathing your pet?

    Shampoo

    Do you have any comments or questions for your nurse?*

    Upload your photos here

    Files must be smaller than 5mb. If your file is larger than 5mb, please email it directly to office@petderm.ca.

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