3604 Rte 378, Bethlehem, PA 18015
nsah@northsauconanimalhospital.com
610‑867‑0800
Our Practice & Staff
Services
Acupuncture
Wellness Care
Dentistry & Dental X-Ray
Puppy and Kitten Care
General Surgery
Laboratory Tests
Digital Radiology & Ultrasound Imaging
Nutritional Counseling
Senior Care
Resources
Testimonials
Online Store
CONTACT US
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Pet Information
Home
»
Pet Information
Pet Information
Pet's Name
*
Birth Date or Age
*
Sex
*
Neutered or Spayed?
*
Last Heat Cycle (female only)
Breed
*
Canine/Feline/Other
*
Color
*
Promo Code
Medical History
Has your pet had any previous medical or surgical problems?
*
Yes
No
If yes, please explain
Has your pet ever had an allergic reaction to a medication?
*
Yes
No
Has your pet ever had a reaction to a vaccine?
*
Yes
No
Is your pet on any medication?
*
Yes
No
If yes, please list:
Does your pet stay inside or outside?
*
Inside
Outside
What do you feed your pet?
*
Who is your pet’s previous veterinarian?
*
May we contact them for medical information if needed?
*
Yes
No
Vaccine History
Please enter date of last vaccine:
Dogs:
Distemper / Parvo virus
Rabies
Bordetella (Kennel cough)
Heartworm Test
Stool check
Cats:
Distemper
Rabies
Leukemia Vaccine
Leukemia Test
Stool check
New Puppies/Kittens:
Where did your pet come from?
Pet Store
Breeder
Stray
Rescue
Pet Owner's Name
*
Email Address
*
3604 Rte 378, Bethlehem, PA 18015
