5201 Virginia Beach Blvd.
Virginia Beach, VA 23462

Map & Directions     Petcare@petcarevb.com

(757) 473-0111

Monday-Friday: 7:30 a.m. - 7:00 p.m.
Saturday: 7:00 a.m. - 1:00 p.m.
Sunday: Closed

Pet Acupuncture at Pet Care Virginia Beach

Dog / Cat Acupuncture Questionnaire

Acupuncture at Pet Care Veterinary Hospital is provided by Dr. Partlow. She has received post-doctoral training in Veterinary Acupuncture at The Chi Institute in Florida. She is a member of The American Association of Traditional Chinese Veterinary Medicine.

Please fill out our acupuncture questionnaire prior to your visit.

Acupuncture Questionnaire

Date:

Owner Name:

Pet Name:

Sex:

Age:

Species:

Breed:

Diet:

Appetite:

Current Medications:

Activity Level:

Stiffness:

If so, which limb?

Vomiting:

Stool:

Cough:

Water Intake:

Urination:

Sleep:

Temperature preference:

Any behavior concerns:

Primary complaint:

Any labwork/xrays/previous records:

Brief history (previous diagnosis/medication/response to treatment):

Pet Care Veterinary Hospital



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Pet Care Veterinary Hospital ©2017
5201 Virginia Beach Blvd. Virginia Beach, VA 23462
Veterinarians in Virginia Beach, Norfolk, Portsmouth, Chesapeake, Hampton, Suffolk, Newport News, and Williamsburg
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