116 Goodwin Road
Durham, NC 27712

(919) 471-0308

Monday – Friday 8 a.m. to 6 p.m.
Saturday 8 a.m. to 1 p.m.
Closed first Saturday of each month

frontdesk@enoanimalhospital.com




116 Goodwin Road Durham, NC 27712
(919) 471-0308
frontdesk@enoanimalhospital.com

Monday – Friday 8 a.m. to 6 p.m.
Saturday 8 a.m. to 1 p.m.
Closed first Saturday of each month




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Inappropriate Urination or Defecation Exam Form

We look forward to seeing you!

Inappropriate Urination or Defecation Exam Form

Please complete our Inappropriate Urination or Defecation Exam Form before your visit. If you have any questions, please feel free to contact us!

Pet parent's name *

Primary phone *

Secondary phone

Preferred method of contact *

Call
Text

Email *

Pet's Name *

Does your pet live *

Indoors
Outdoors
Both

Regular diet (brand and type) *

Amount fed per day *

How long has your pet been on his/her current diet? *

Do you give your pet any treats? *

Yes
No

Do you give your pet any people food? *

Yes
No

Indicate any applicable health symptoms and their severity

Weight *

Gain
Loss
No Change

Is the change in weight

Mild
Moderate
Severe

How long have you noticed the problem? *

Appetite *

Increase
Decrease
No Change

Is the change in appetite

Mild
Moderate
Severe

How long have you noticed the problem? *

Drinking *

Increase
Decrease
No Change

Is the change in drinking *

Mild
Moderate
Severe

How long have you noticed the problem? *

Urinating *

Increase
Decrease
No Change

Is the change in urination *

Mild
Moderate
Severe

How long have you noticed the problem? *

Activity level *

Increase
Decrease
No Change

Is the change in activity level *

Mild
Moderate
Severe

How long have you noticed the problem? *

Urinary accidents? *

Yes
No

Fecal accidents? *

Yes
No

Difficulty walking/jumping/posturing to potty? *

Yes
No

Any new pets in the house? *

Yes
No

Is your pet on heartworm prevention? *

Yes
No

Is your pet on flea and tick prevention? *

Yes
No

Is your pet currently taking any medication? *

Yes
No

Please list any existing medical conditions.

Any other problems or concerns?

Do you authorize Eno Animal Hospital to perform diagnostics and/or treatment as deemed necessary and appropriate by a veterinarian up to $200? *

Yes
No, call me first

If your pet is new to Eno, do you have your pet's medical records? (Please check "No" for established patients, as we already have your pet's medical records.) *

Yes
No

Medical Records

Click or drag a file to this area to upload.

What insurance should we send the visit records to? *

My pet does not have insurance.
Please send to...

Please send to...

Signature *

Clear Signature

Date *

Comment

Eno Animal Hospital: Your Other Family Doctor

For more than 30 years, Eno Animal Hospital has been a trusted partner for pet parents seeking exceptional veterinary care and compassion in Durham, Bahama, Butner, Rougemont, Creedmoor, and surrounding communities.

At Eno Animal Hospital, your pet’s wellness is our priority. We’re Fear Free pros who believe in caring for the whole pet. We have everything your pet needs under one roof. Book your first visit today and get $40 off! Put your pet in the best hands at Eno.

Eno Animal Hospital offers wellness care, treatments, surgery, dentistry, lab work, laser therapy, acupuncture, grooming, boarding, and more in Durham, Bahama, Butner, Rougemont, Creedmoor, and surrounding communities.

SAY HELLO!

We’d love to hear from you!

Name *

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Last

Email *

Phone

How can we help you? *

Message

We Proudly Serve Pets of Durham, NC, and Beyond

Bahama
Rougemont
Creedmoor
Butner

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