(919) 471-0308 frontdesk@enoanimalhospital.com

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Wellness Exam

BOOK A VISIT

We look forward to seeing you!

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

Pet Parent's Name *

First

Last

Primary Phone *

Secondary Phone

Preferred method of contact *

Call
Text
Either

Email *

Pet's Name *

My pet lives: *

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

What kind? *

Do you give your pet any people food? *

Yes
No

What kind? *

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? *

Does your pet have any lumps/tumors? *

Yes
No

Are the lumps/tumors: *

Mild
Moderate
Severe

How long have you noticed the problem? *

Describe the location of the lumps/tumors *

Does your pet have any skin problems? *

Yes
No

Are the skin problems: *

Mild
Moderate
Severe

How long have you noticed the problem? *

Describe the location *

Does your pet have bad breath/difficulty chewing? *

Yes
No

Is the bad breath/difficulty chewing: *

Mild
Moderate
Severe

How long have you noticed the problem? *

Any scratching/chewing/sneezing? *

Yes
No

Is the scratching/chewing/sneezing: *

Mild
Moderate
Severe

How long have you noticed the problem? *

Any behavioral issues or changes? *

Yes
No

How long have you noticed the change in behavior? *

Describe the behavior *

Vomiting? *

Yes
No

Describe the consistency *

When did it start? *

Frequency? *

Is your pet able to keep down water? *

Yes
No

Any new pets in the house? *

Yes
No

Type *

When? *

Is your pet on heartworm prevention? *

Yes
No

Brand *

Last dose given *

Is your pet on flea and tick prevention? *

Yes
No

Brand *

Last dose given *

Is your pet currently taking any medication? *

Yes
No

Please list any medications your pet is currently taking (include name, dosage, and frequency) *

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

Signature *

Date *

Download our app and connect with us on PetDesk!

Keeping up with your pet’s health from your mobile device has never been easier. With our app, you’ll have all your pet’s health information in the palm of your hand. Plus, you’ll be able to communicate with us easily—and enroll in our Paw Perks program to earn loyalty points for free Eno products and services! In PetDesk, you can...

Request visits 24/7
Receive automatic health reminders
Save notes, pics, and more

Questions about PetDesk? Our contact information can be found at the bottom of this page!

Say hello!

We’d love to hear from you!

Name *

First

Last

Email *

Phone

How can we help you? *

Email

Monday – Friday:

8 am – 6 pm

Saturday:

8 am – 1 pm

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Visit Us

116 Goodwin Road, Durham, NC 27712

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Email Us

frontdesk@enoanimalhospital.com

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