Please fill out our patient forms using one of the options below if your pet is an existing patient at Stoney Trail Veterinary Clinic.

Patient Forms

Click the toggles below to complete your form. If you’re submitting multiple forms, you must click submit after each completed form.

Cat / Dog Health Questionnaire

Owner Information

Owner First Name

Owner Last Name

Phone

Any changes in your contact info (phone, address, email)? If yes please provide below:

Patient Information

Patient Name

Medication

Please list all current medications/supplements. Include dosages and frequency if possible.

Diet

Please list your pet's current diet. Include the brand, flavor, amount, and frequency.

Please list anything extra that your pet eats in a day.

Have there been any recent changes in your pet's diet?

Yes

No

Medical Concerns

Please check each symptom, that applies to your pet, below.

Increase/Decrease in Appetite

Increase/Decrease in Drinking

Increase/Decrease in Weight

Change in Frequency of Urination/Amount of Urine

Diarrhea or Vomiting (please note in the box below how often and any specific time of day)

Problems with Control of Urination or Bowel Movements

Behavioral Changes/Abnormal Behavior (i.e. increased aggression, disinterested, uncharacteristic behaviors)

Apparent Confusion, Disorientation, Pacing, or Imbalance Concerns

Irregular Sleep Patterns/Restless at Night

Limping, Stiff Gait, Discomfort, or Trouble Doing Normal Daily Activities

Lethargy

Itchy, Irritated, and/or Flaky Skin

New or Changing Masses or Lumps

Head Shaking, Dirty Ears, or Scratching Obsessively at Ears

Coughing and/or Sneezing (please note in the box below, if the cough is productive/non-productive and if nasal discharge is colored or clear)

Concerns with Oral Health

No Concerns

Please provide details on any of the medical concerns selected above.

Lifestyle

What would you say best describes your pet's lifestyle?

Indoor

Outdoor

Both

Does your pet have any access to rodents or wild animal meat? (i.e. catches mice, unsupervised time outside, given hunting meat, etc)

Yes

No

Travel

Has your pet been out of the province in the last year or plan to be out of the province in the next year?

Yes

No

If yes, please indicate where your pet may be travelling

Please check any extracurricular activities that your pet participates in:

Daycare

Dog Park

Grooming

Pet Store

Camping

Swimming

Hunting

Cat or Dog Show

Hiking

Travel

None of the Above

Preventive Health Care

Is your pet currently on a deworming protocol?

Yes

No

If so, please indicate the product, frequency of administration and last administration.

Is your pet currently on flea/tick prevention?

Yes

No

If so, please list the product and frequency of administration.

Has your pet had any previous vaccine reaction(s)? (i.e. vomiting, diarrhea, lethargy, soreness, swelling, or hives)

Yes

No

Spam Blocker
Cat / Dog Senior Wellness Questionnaire

Owner Information

Owner First Name

Owner Last Name

Phone

Any changes in your contact info (phone, address, email)? If yes please provide below:

Patient Information

Patient Name

Diet

What diet is your pet currently on?

Kibble

Canned

Raw

What brand or specific type of food is your pet on?

How often does your pet get fed?

Once a day

Twice a day

Food always available

How many cups / cans does your pet get fed in a day?

Please list anything extra that your pet eats in a day.

Is your pet on any supplements (omegas, glucosamine, etc)? Please Describe:

Has there been any change in appetite recently?

Yes

No

Health & Behaviour

Has your pet been experiencing any of the following symptoms? (If yes, please check)

Difficulty climbing stairs

Difficulty jumping up

Increased stiffness or limping

Loss of housetraining

Increased thirst

Increased urination

Changes in activity level

Excessive panting

Other changes in breathing pattern

Coughing

Circling or repetitive movements

Aimlessly wanders or paces

Follows you everywhere

Less interaction with family

Decreased responsiveness

Appears lost in yard or house

Sleeps more during the day

Stares into space or at walls

Sleeps less at night

Increased vocalization

Increased anxiety

Increased aggression or irritability

Changes in skin and/or coat

New lumps and/or bumps

Excessive scratching

Muscle tremors or shaking

Less enthusiastic greetings

Increased appetite

Decreased appetite

Vomiting

Changes in bowel movements

Weight loss

Weight gain

Difficulty hearing

Vision problems

Difficulty chewing / playing with toys

Bad breath

If yes to any of the above please elaborate below:

Spam Blocker
Avian Patient Form

Owner Information

Owner First Name:

Owner Last Name:

Phone:

Any changes in your contact info (phone, address, email)? If yes please provide below:

Patient Information

Patient Name:

Environment

What type of enclosure is used?

What substrate is used in the enclosure?

What is the cleaning routine?

Are there any other animals in the house or sharing the enclosure?

Any changes in environment since last visiting?

Diet

Describe the diet (what and how much or how often offered)

Any supplements / vitamins? If yes, what kind?

Any changes in diet since last visit?

Any other changes to your birds care since last visit?

Health

Any changes or concerns (behavior, eating, energy, egg laying, etc)

Any updates to your birds medical history since last visit (visits to other veterinary clinics or testing performed)

Social Media Release

Do you consent to Stoney Trail Veterinary Clinic photographing and/or recording your pet(s) during visits and using these images or recordings for educational, promotional, and social media purposes? No personal identifying information will be shared without additional consent and you may withdraw this permission in at any time.

Yes

No

Spam Blocker
Exotic Mammal Patient Form

Owner Information

Owner First Name:

Owner Last Name:

Phone:

Any changes in your contact info?

Patient Information

Patient Name:

Environment

What type of enclosure is used?

What substrate is used in the enclosure?

What is the cleaning routine?

Are there any other animals in the home or sharing the enclosure?

Any changes in environment since last visiting?

Diet

Describe the diet (what and how much or how often offered)

Any supplements / vitamins? If yes, what kind?

Any changes in diet since last visiting?

Any other changes to your pet's care since last visit?

Health

Any changes or concerns (behavior, eating, energy, etc)

Any updates to your pet's medical history since last visit (visits to other veterinary clinics or testing performed)

Social Media Release

Do you consent to Stoney Trail Veterinary Clinic photographing and/or recording your pet(s) during visits and using these images or recordings for educational, promotional, and social media purposes? No personal identifying information will be shared without additional consent and you may withdraw this permission in at any time.

Yes

No

Spam Blocker
Reptile Patient Form

Owner Information

Owner First Name:

Owner Last Name:

Phone:

Any changes in your contact info?

Patient Information

Patient Name:

Environment

What type of enclosure is used?

What substrate is used in the enclosure? (sand, astroturf, paper towel, etc.)

What is the cleaning routine?

Are there any other animals in the home or sharing the enclousure?

Any changes in the environment since last visiting?

Diet

Describe the diet (what and how much or how often offered)

Any supplements / vitamins? If yes, what kind?

Any changes in diet since last visiting?

Any other changes to your reptile's care since last visit?

Health

Any changes or concerns (behavior, eating, energy, etc)

Any updates to your reptile's medical history since last visit (visits to other veterinary clinics or testing performed)

Social Media Release

Do you consent to Stoney Trail Veterinary Clinic photographing and/or recording your pet(s) during visits and using these images or recordings for educational, promotional, and social media purposes? No personal identifying information will be shared without additional consent and you may withdraw this permission in at any time.

Yes

No

Spam Blocker

Cat / Dog Health Questionnaire
Cat / Dog Senior Wellness Questionnaire
Avian Patient Form
Exotic Mammal Patient Form
Reptile Patient Form

Owner Information

Owner First Name *

Owner Last Name *

Phone *

Any changes in your contact info (phone, address, email)? If yes please provide below:

Patient Information

Patient Name *

Medication

Please list all current medications/supplements. Include dosages and frequency if possible. *

Diet

Please list your pet's current diet. Include the brand, flavor, amount, and frequency. *

Please list anything extra that your pet eats in a day. *

Have there been any recent changes in your pet's diet? *

Yes

Medical Concerns

Please check each symptom, that applies to your pet, below. *

Increase/Decrease in Appetite

Increase/Decrease in Drinking

Increase/Decrease in Weight

Change in Frequency of Urination/Amount of Urine

Diarrhea or Vomiting (please note in the box below how often and any specific time of day)

Problems with Control of Urination or Bowel Movements

Behavioral Changes/Abnormal Behavior (i.e. increased aggression, disinterested, uncharacteristic behaviors)

Apparent Confusion, Disorientation, Pacing, or Imbalance Concerns

Irregular Sleep Patterns/Restless at Night

Limping, Stiff Gait, Discomfort, or Trouble Doing Normal Daily Activities

Lethargy

Itchy, Irritated, and/or Flaky Skin

New or Changing Masses or Lumps

Head Shaking, Dirty Ears, or Scratching Obsessively at Ears

Coughing and/or Sneezing (please note in the box below, if the cough is productive/non-productive and if nasal discharge is colored or clear)

Concerns with Oral Health

No Concerns

Please provide details on any of the medical concerns selected above.

Lifestyle

What would you say best describes your pet's lifestyle? *

Indoor

Outdoor

Both

Does your pet have any access to rodents or wild animal meat? (i.e. catches mice, unsupervised time outside, given hunting meat, etc) *

Yes

Travel

Has your pet been out of the province in the last year or plan to be out of the province in the next year? *

Yes

If yes, please indicate where your pet may be travelling

Please check any extracurricular activities that your pet participates in: *

Daycare

Dog Park

Grooming

Pet Store

Camping

Swimming

Hunting

Cat or Dog Show

Hiking

Travel

None of the Above

Preventive Health Care

Is your pet currently on a deworming protocol? *

Yes

If so, please indicate the product, frequency of administration and last administration.

Is your pet currently on flea/tick prevention? *

Yes

If so, please list the product and frequency of administration.

Has your pet had any previous vaccine reaction(s)? (i.e. vomiting, diarrhea, lethargy, soreness, swelling, or hives) *

Yes

Spam Blocker

Owner Information

Owner First Name *

Owner Last Name *

Phone *

Any changes in your contact info (phone, address, email)? If yes please provide below:

Patient Information

Patient Name *

Diet

What diet is your pet currently on? *

Kibble

Canned

Raw

What brand or specific type of food is your pet on? *

How often does your pet get fed? *

Once a day

Twice a day

Food always available

How many cups / cans does your pet get fed in a day? *

Please list anything extra that your pet eats in a day. *

Is your pet on any supplements (omegas, glucosamine, etc)? Please Describe: *

Has there been any change in appetite recently? *

Yes

Health & Behaviour

Has your pet been experiencing any of the following symptoms? (If yes, please check) *

Difficulty climbing stairs

Difficulty jumping up

Increased stiffness or limping

Loss of housetraining

Increased thirst

Increased urination

Changes in activity level

Excessive panting

Other changes in breathing pattern

Coughing

Circling or repetitive movements

Aimlessly wanders or paces

Follows you everywhere

Less interaction with family

Decreased responsiveness

Appears lost in yard or house

Sleeps more during the day

Stares into space or at walls

Sleeps less at night

Increased vocalization

Increased anxiety

Increased aggression or irritability

Changes in skin and/or coat

New lumps and/or bumps

Excessive scratching

Muscle tremors or shaking

Less enthusiastic greetings

Increased appetite

Decreased appetite

Vomiting

Changes in bowel movements

Weight loss

Weight gain

Difficulty hearing

Vision problems

Difficulty chewing / playing with toys

Bad breath

If yes to any of the above please elaborate below:

Spam Blocker

Owner Information

Owner First Name: *

Owner Last Name: *

Phone: *

Any changes in your contact info (phone, address, email)? If yes please provide below:

Patient Information

Patient Name: *

Environment

What type of enclosure is used? *

What substrate is used in the enclosure? *

What is the cleaning routine? *

Are there any other animals in the house or sharing the enclosure? *

Any changes in environment since last visiting? *

Diet

Describe the diet (what and how much or how often offered) *

Any supplements / vitamins? If yes, what kind? *

Any changes in diet since last visit? *

Any other changes to your birds care since last visit? *

Health

Any changes or concerns (behavior, eating, energy, egg laying, etc) *

Any updates to your birds medical history since last visit (visits to other veterinary clinics or testing performed) *

Social Media Release

Do you consent to Stoney Trail Veterinary Clinic photographing and/or recording your pet(s) during visits and using these images or recordings for educational, promotional, and social media purposes? No personal identifying information will be shared without additional consent and you may withdraw this permission in at any time. *

Yes

Spam Blocker

Owner Information

Owner First Name: *

Owner Last Name: *

Phone: *

Any changes in your contact info? *

Patient Information

Patient Name: *

Environment

What type of enclosure is used? *

What substrate is used in the enclosure? *

What is the cleaning routine? *

Are there any other animals in the home or sharing the enclosure? *

Any changes in environment since last visiting? *

Diet

Describe the diet (what and how much or how often offered) *

Any supplements / vitamins? If yes, what kind? *

Any changes in diet since last visiting? *

Any other changes to your pet's care since last visit? *

Health

Any changes or concerns (behavior, eating, energy, etc) *

Any updates to your pet's medical history since last visit (visits to other veterinary clinics or testing performed) *

Social Media Release

Yes

Spam Blocker

Owner Information

Owner First Name: *

Owner Last Name: *

Phone: *

Any changes in your contact info? *

Patient Information

Patient Name: *

Environment

What type of enclosure is used? *

What substrate is used in the enclosure? (sand, astroturf, paper towel, etc.) *

What is the cleaning routine? *

Are there any other animals in the home or sharing the enclousure? *

Any changes in the environment since last visiting? *

Diet

Describe the diet (what and how much or how often offered) *

Any supplements / vitamins? If yes, what kind? *

Any changes in diet since last visiting? *

Any other changes to your reptile's care since last visit? *

Health

Any changes or concerns (behavior, eating, energy, etc) *

Any updates to your reptile's medical history since last visit (visits to other veterinary clinics or testing performed) *

Social Media Release

Yes

Spam Blocker

Existing Patient Forms

Patient Forms

Owner Information

Patient Information

Medication

Diet

Medical Concerns

Lifestyle

Travel

Preventive Health Care

Owner Information

Patient Information

Diet

Health & Behaviour

Owner Information

Patient Information

Environment

Diet

Health

Social Media Release

Owner Information

Patient Information

Environment

Diet

Health

Social Media Release

Owner Information

Patient Information

Environment

Diet

Health

Social Media Release

Owner Information

Patient Information

Medication

Diet

Medical Concerns

Lifestyle

Travel

Preventive Health Care

Owner Information

Patient Information

Diet

Health & Behaviour

Owner Information

Patient Information

Environment

Diet

Health

Social Media Release

Owner Information

Patient Information

Environment

Diet

Health

Social Media Release

Owner Information

Patient Information

Environment

Diet

Health

Social Media Release

New Patients Welcome