Patient History Form

Please answer the questions below and click submit.

  • Owner Information

  • Pet's Skin Health Information

    By providing us with this information ahead of your visit time, you will greatly facilitate your visit and decrease your appointment length. Thank you for allowing us to help your pet.
  • Patient's Dermatological History

  • Examples: monthly flea/tick/heartworm medications (i.e. chewed or flavored?), antibiotics (i.e. cephalexin), antifungals (i.e. ketoconazole), antihistamines (i.e. benadryl), fatty acids, steroids (i.e. prednisone), topical medications/creams/ointments/sprays, 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


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.



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