If you have made a Senior Health Check Appointment, please fill out our online form below. Title* DrMissMsMrsMrOther Owner(s) Full Name* Mobile* Email Address* Mailing Address* Pet Name* Pet Weight Does your pet enjoy exercise?* More than previouslyLessSame Do they have trouble climbing stairs/jumping into a car or onto furniture?* YesNo Do they ever cough?* YesNo Does their breath smell?* YesNo Do they seem listless or have less interest in food?* YesNo What food do they currently eat?* How much do they eat in one day?* Do you think your pet has lost weight recently?* YesNo Is your pet drinking more than usual?* YesNo Have you noticed any lumps or bumps on your pet?* YesNo Is your pet scratching more than usual?* YesNo Has your pet ever had a funny turn or collapsed?* YesNo Have you noticed any changes to your pet's faeces or urine? (ie. consistency, frequency, presence of blood, need to strain)* YesNo Has your pet had any vomiting or diarrhoea recently?* YesNo Has your pet started to urinate or defecate in the house?* YesNo If your pet is a dog - has their bark changed recently?* YesNoNot applicable Has your pet developed a decreased tolerance to being left alone?* YesNo Does your pet interact with you and the family as they used to?* YesNo If you have any comments on any of the above, or any other concerns, please note them here: Last updated on 11 April 2024