Patient History Form

Please answer the questions below and click submit.

  • Owner Information

  • Patient Information

  • Patient's Dermatological History

  • Examples: antibiotics (i.e. cephalexin), antifungals (i.e. ketoconazole), antihistamines (i.e. benadryl), fatty acids, steroids (i.e. prednisone), topical medications/creams/ointments/sprays, flea/tick/heartworm medications (i.e. chewed or flavored?), shampoos/conditioners, other/supplements
  • Pet food (include brand), treats, rawhides/bones, other (human food?)
  • Examples: weight loss, weight gain, drinking more water/urinating more frequently, vomiting, diarrhea, weakness/low energy level, excessive hunger relative to normal for your pet, other

University of Florida

IFAS

As part of both the Institute of Food and Agricultural Sciences and UF Health, Veterinary Medicine is dedicated to advancing animal, human and environmental health through teaching, research, extension and patient care.

IFAS

UNIVERSITY OF FLORIDA

Animal Hospitals

Need animal care? Visit the UF Small Animal and Large Animal Hospitals. From dogs, cats, birds and exotics to horses, cattle, llamas, pigs and many other large farm or food animals, our experienced veterinary staff is ready to assist.

Animal Airwaves

Syndicated Podcast

Animal Airwaves

Animal Airwaves is a daily radio series that features one-minute segments relating to animal health, ranging from insights into animal behavior to veterinary patient care breakthroughs and trends.

Animal Airwaves