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Client Information
Household/Environment Details
Client: SUZANNE OWINGS
Email: [email protected]
Phone: 770-942-3303
Other Pets: No YES
Other Pets Affected : No NO
Littermates or Parents Affected: No NO
People in Home Affected: No NO
Pet Information
Flea Control / Bathing
Pet's Name: CARSON
Date of Birth: 06/25/2009
Date Acquired: 09/25/2009
Spayed: 01/15/2011
Condition
Flea Control on Pet: No NO
Environmental Flea Control in Home/Yard: No FLEABUSTERS
How Often Pet Is Bathed: EVERY 60 DAYS
Shampoos/Bathing Products: BUDDY WASH AND
CONDITIONER
Diet
Complaint: SPOT ON NOSE
Problem Started: 08/13/2012
Time Spent Indoors: 75%
Condition is Currently: continuous
Was It Initially Seasonal: no
Time Condition is Less Severe: No NO
Occasions Symptoms are Worse: No ALWAYS THE SAME
Diet - Foods & Treats: RAW MEAT AND ORGANIC KIBBLE
How Long On This Diet: 3 YEARS
Vitamins or Supplements: OMEGA 3 & PITCARIN'S HEALTHY
POWDER
Bowel Movements Daily: 2
Onset and History of Symptoms
Previous Treatments
First indications of problem: redness
Where did the problem start: nose
Areas pet may scratch, rub, check, lick or bite?
Has Problem Spread? No NO
How Itchy: 1 out of 10
Medications For Skin Condition: NO
Other Medications: NO
Medications That Helped: No NO
Times Treated for Condition: 0
Treated for Stomach or Intestinal Problems: No NO
Symptoms Pet Exhibits
Clinic
Cough: No
Runny Nose: No
Diarrhea: No
Loss of Appetite: No
Urinate Excessively: No
Sneeze: No
Ear Infections: No
Vomit: No
Drink Excessively: No
Limp: No
Animal Dermatology Clinic
1453 Terrell Mill Rd SE, Suite 119
Marietta, Georgia 30067
Phone: (770) 422-2509
Fax: (770) 422-8750
Email: [email protected]
Please bring, email or fax this document to the clinic selected above.