Urgent Care Appointments Available 503-821-7070.

Online Forms

Abdominal Ultrasound Patient History Form

Fern Hill Veterinary Care

Abdominal Ultrasound Patient History Form

Save time in the office by filling out your forms online. We’ll review your forms and get back to you promptly, all before your next visit! Thank you for choosing Fern Hill Veterinary Care.

Client Name(Required)

First Last

Email(Required)

Phone(Required)

Pet Information

Pet's Name(Required)

How long have you owned your pet?(Required)

How did you obtain your pet?(Required)

What are your main concerns for your pet's health? What symptoms are you seeing at home that worry you?(Required)

How long have these concerns been present?(Required)

Does your pet spend time primarily indoors, outdoors, or both?(Required)

Indoors

Outdoors

Both

Do you have a multiple pet household?(Required)

Yes

Is your pet having vomiting or diarrhea? If yes, please describe the appearance (blood, mucus, bile, consistency, etc) and frequency:(Required)

Is your pet having breathing difficulties or coughing? If yes, please describe (panting, noisy breathing, wet or honking cough, etc):(Required)

Is your pet having sneezing or nasal discharge? If yes, please describe the frequency and appearance:(Required)

What diet does your pet eat (brand and type, main ingredients if known):(Required)

Is your pet's appetite normal? If not, please describe whether appetite is increased or decreased:

Is your pet drinking a normal amount of water? If not, please describe whether the water intake is increased or decreased:

Is your pet urinating normal volumes? If not, please describe whether urine volume is increased or decreased:

Is your pet having any difficult or painful urinations?

Has your pet lost weight recently?:(Required)

Yes

Does your pet have a normal activity level? If not, please describe:(Required)

Is your pet's behaviour normal? If not, please describe:(Required)

Have you noted any abnormal bleeding? (from the gums or nose, in the urine/feces, etc):(Required)

Has your pet traveled outside the Pacific Northwest in the past year?(Required)

Is your pet up-to-date on routine vaccinations?(Required)

Yes

Does you pet receive monthly heartworm and flea preventatives?(Required)

Yes

Have you seen a tick attached to your pet in the past six months?(Required)

Yes

What medications and/or supplements (including herbs and vitamins) are you giving your pet? If available, please provide the doses:(Required)

Does your pet have any previously diagnosed medical problems?:(Required)

This field is for validation purposes and should be left unchanged.

Serving Pets of the Happy Valley Community

We proudly serve the pets of Happy Valley, Damascus, Milwaukie, Portland, Gladstone, and Clackamas.

Have a question?

Complete our online form and we will be in touch shortly!

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Address

12930 SE 162nd Ave #101, Happy Valley, OR 97086

Contact

P: 503-821-7070
E: hello@fernhillvet.com

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Hours

Mon – Fri: 9:00 am – 6:00 pm
Sat: 9:00 am – 2:00 pm
Sun: Closed

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