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24 Hour Emergency & Critical Care
Current Wait Time for ER: Minutes Please call us before coming in to discuss your pet's current condition.
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K9 Rec Center History Form

Prior to your appointment with our Rehabilitation and Integrative Medicine Department, please complete and submit the following form. Thank you and we look forward to seeing you at your upcoming appointment.

Name*
First Last
Phone*
Email*
General Background
Pet's Name*
First
What type is your dog?*
I am this dog's*
- Owner
- Handler
- Hauler/Transporter
What type of work does your dog do?*
Examples: guide dog, field trial, agility, patrol, detection, etc.
What is the status of your dog's career?*
Examples: pup, in training, active, retired, etc.
What is your dog's length of service/competition?*
Any history of bite training?*
- Yes
- No
How are they with people?*
Examples: cooperative, avoidant, indifferent, defensive, offensive, etc.
Will they follow English commands and or cues from people other than their handler?*
- Yes
- No
Are they reactive to other dogs?*
- Yes
- No
Is your pet muzzle trained and/or do you recommend we muzzle them for rehab purposes?*
What type of reward can we use for rehabilitation purposes?*
Examples: toy, praise, food, etc.
Are you bringing a specific reward for us to use?*
- Yes
- No
Does your dog have any specific handler behaviors, triggers or environmental cues we need to avoid?*
How did you hear about the VSC K9 ReC Center? (Examples: website, event, personal referral)*
- website
- event
- personal referral
Medical History
Does your dog have any existing health conditions?*
Has your dog had any prior surgeries?*
If yes, please list type and general date.
What medications and/or supplements is your dog currently taking?*
Has your dog done any physical rehabilitation in the past? Or are they currently in physical rehabilitation?*
Has your dog done any fitness or conditioning work specifically in the past?*
What types of specific actions do they do on a daily basis?*
Examples: jumps, climbing, diving, etc.
Does your dog have any allergies to food or medications?*
Is your dog up-to-date on core (Rabies, DA2P) and elective (e.g., Lepto, Lyme, Flu) vaccines?*
IF CLICKING SUBMIT BUTTON BELOW DOES NOT DISPLAY SUBMISSION SUCCESSFUL, PLEASE SCROLL UP, CORRECT ANY FIELDS HIGHLIGHTED IN RED, AND TRY AGAIN.