COVID-19 Update
727-725-1691
Emergencies
Online Store
Request Appointment

Home
About Us
- Meet Our Team
- Testimonials
Our Services
Wildlife
Pet Owners
Contact Us
- Request Appointment

Home
About Us
- Meet Our Team
- Testimonials
Our Services
Wildlife
Pet Owners
Contact Us
- Request Appointment

Illness/Injury Pet History Form

Owner Contact Information
Name*
First Last
Phone*
Pet Information - Required History
Pet's Name*
Is your pet on any medications?*
- Yes
- No
Which medication?
What percentage of time does your pet spend outside?*
- 0%
- 50%
- 100%
Have you seen any fleas or ticks on your pet?*
- Yes
- No
Does your pet come into contact with other animals not in your home? Please check all that apply*
- None
- Boarding
- Grooming
- Dog Parks
- Other
Appointment Information
What's the reason for your visit? (check all that apply)
- Appetite Change
- Changes in drinking
- Weight Loss
- Weight Gain
- Itching/Scratching
- Shaking Head
- Bad Breath
- Vomiting
- Diarrhea
- Changes in urination
- Excessive Sleeping
- Scooting
- Difficulty getting up
- Skin Masses (explain below)
- Behavioral concerns (explain below)
- Changes in activity
- Limping
- Hair loss
- Coughing/Sneezing
- Eye discharge
- Seizures
- Other (explain below)
Please describe the issue.
When did you start noticing the problem?
Has your pet had this problem before?
- Yes
- No
Please explain
Did you give your pet any medications or treatments for this issue?
- Yes
- No
Which medications?
When is the last time your pet ate?
What is your pet's typical diet?
Has your pet ever had any adverse reaction to any medications, vaccination, or other procedure?
- Yes
- No
Any additional information you feel would be helpful for the doctor?

Contact Us

701 Enterprise Road E
Safety Harbor, Florida 34695

Phone: 727-725-1691
Fax: 727-725-1693

Hours

Mon, Thurs, Fri: 7:30 am to 5:30 pm
Tues: 7:30 am to 8 pm
Wed: 7:30 am to 4:30 pm
Sat: 8 am to Noon
Sun: Closed

Cat Friendly

Care Credit

© 2021 . Designed & Managed by ViziSites. Terms of Use.

Temporary Office Closure

We will be closed July 14 and 15th while our hospital undergoes renovations.

We will reopen July 16th at 7:30am.

In the event of an emergency please contact Blue Pearl.

You can request an appointment here:

Request Appointment

Same day exam fee would apply.

We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept All”, you consent to the use of ALL the cookies. However, you may visit "Cookie Settings" to provide a controlled consent.

Cookie Settings Accept All

Manage consent

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.

Necessary

Always Enabled

Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.

Non-necessary

Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.

SAVE & ACCEPT