Name: Campus Estates Animal Hospital
Address: 1460 Gordon Street South, Guelph, ON, N1L 1C8, CA
Telephone: 519-837-1212

Client Details
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number
Email Address
Dog Details
Name
Age (date of birth)
Sex
Is your dog spayed or neutered?
Breed
History
Are any of the other pets sick or have illnesses; if yes please list.
Description of your dogs clinical symptoms; what is wrong with your pet.
is your pet experiencing any of the following;
- Coughing
- Sneezing
- Vomiting
- Diarrhea
- Regurgitation
- Lameness - if yes please be specific.
Lameness - if yes please be specific.
What does your pet eat. Please be specific include brand, amount fed and treats that your pet eats.
Please list all medications that your pet is currently on including times when given.
Please list any previous problem you have had with your pet.
when did your pet have his or her last fecal screening and blood work?
Please include any other information that would be helpful.

For appointments please call 519-837-1212 Make an Appointment

Client Details

Dog Details