SHERIDAN ANIMAL HOSPITAL 2288 Sheridan Drive • Buffalo, New York 14223 Telephone (716) 833-2255 • Fax (716) 833-8525
What breed is your dog?
Birth-date or approx. age:
Where did you obtain your dog?
How long have you had your dog?
Is your dog Microchipped? YesNo
If yes, what is the microchip number?
What kind of dog food do you feed? WetDryBoth
How much & how often? (ex. 1 cup, 2x a day)
What kind of treats do you feed?
How many & how often? (ex. 2 treats in the morning and 2 treats before bed)
Is your dog’s housing primarily: Indooror Outdoor?
Do you have any other pets at home?
What activities does your dog (or do you plan for your dog) to participate in? (Check all that apply). Walks in the neighborhoodObedience schoolBoarding kennelHuntingDog showsObedience/agility trialsCamping/HikingGroomingBreedingWalks on bike pathShopping at pet storesPlay at dog parksWorking (please describe)
Describe (if applicable):
Has your dog ever had any serious illness in the past? Please explain.
Is your dog currently on any medication or supplements? YesNo
If yes, please list the drug, strength and dosing directions:
Is your dog up to date with vaccinations? YesNo
List vaccines and when due if known.
Are there any specific health or behavioral questions you would like to discuss at your visit?
Send Us A Line! Phone: (716) 833-2255 Fax: (716) 833-8525
Veterinary Specialists of WNY: (716) 833-5345
Get Directions 2288 Sheridan Drive Buffalo, NY 14223
M, W, F 7am – 6pm T, TH 7am – 8pm Saturday 8am – 12pm Sunday Closed