Dr. Rigterink will be out of the country from Saturday, July 18, through Tuesday, July 28. If you are a current client and require a prescription refill during this time, please contact your primary care veterinarian to obtain the refill while she is unavailable.

Recheck Behavior History Form

Please answer the following questions below. Detailed information is critical for our doctors to modify and make recommendations for your pet’s treatment program.

Owner's Name *

First

Last

Email *

Pet's Name *

Pet’s Current Medications (name, dosage, frequency of administration): *

Have there been any changes to your personal information since your last appointment? (change of address, change of phone number/email, etc.) *

Primary Veterinarian and any other Veterinarians seen in the last 2 years.

Please provide us with a general update about your pet’s progress, as well as any concerns you may have since our last appointment: *

What behavior management and modification have you been working on with your pet since we last saw them in-office? *

Please give an update on how they are doing on their current medication(s): *

What are your goal(s) for your pet going forward? *

Do you have any concerns and/or questions we need to discuss at the recheck visit?