Gastrointestinal Questionnaire

Your Pet's Name*
Your Name*
First Last
Your Email Address*
Your Phone Number*
Secondary Name on Account, if Applicable*
First Last
Does your pet have diarrhea?
- Yes
- No
- I don't know
If yes, how long has your pet had diarrhea?
If yes, is the diarrhea
- Getting worse
- Getting better
- Staying the same
Describe the consistency of the stool.
- Water/liquid
- Soft
- Normal
- Firmer than normal
What is the color of your pets stool?
Have you noticed blood in the stool?
- Yes
- No
- I don't know
Have you noticed mucus in the stool?
- Yes
- No
- I don't know
Does your pet strain during its bowel movements?
- Yes
- No
- I don't know
Have you noticed an increased frequency in your pet's bowel movements?
- Yes
- No
- I don't know
Have you noticed any intestinal parasites (worms) in your pet's stool?
- Yes
- No
- I don't know
If yes what do they look like?
- Spaghetti
- Rice
Is your pet vomiting?
- Yes
- No
If yes, please describe how long/frequent your pet has been vomiting:
If yes, is vomiting:
- Getting worse
- Getting better
- Staying the same
Describe your pet's appetite:
Describe your pet's water intake:
What do you feed your pet? Include treats and table food if applicable:
What is your pet's activity level?
Does your pet go outside?
- Yes
- No
If yes, is your pet supervised while it is outside?
Does your pet have any unusual cravings?
Are there any other pets in the household?
- Yes
- No
If yes, are any of them vomiting or experiencing diarrhea?
- Yes
- No
Does your pet have excessive gas (flatulence)?
- Yes
- No

Get In Touch

We’d love to hear from you! Use our online form to request an appointment, or give us a call to book over the phone. Contact us any time with questions or concerns.

Address

2755 Fuller Ave.
NE, Grand Rapids, MI 49505

Contact Us

P: (616) 363-3831
@: info@grvetclinic.com

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Hours

Monday: 9:00am-5:00pm
Tuesday: 9:00am-5:00pm
Wednesday: 9:00am-5:00pm
Thursday: 9:00am-5:00pm
Friday: 9:00am-5:00pm
Saturday: Closed
Sunday: Closed