Client Pre-Visit Intake

CLIENT PRE-VISIT PORTAL SUBMISSION IMPORTANT: Client-submitted information is unverified until clinician review. Physical food, treat, supplement and medication samples/packages were requested for RAC testing and label verification. OWNER / PATIENT Owner: Bright Email: brightsinnoosa@gmail.com Phone: 0435565909 Patient: Eddy Species: Dog Breed: Border Collie Sex / desexed status: male Age: Weight kg: EXISTING CLIENT / PATIENT MATCHING DETAILS Previous client?: Yes Alternate / partner owner name: Possible registered owner: Previous patient name: PRIMARY CONCERN Check up.v2 HISTORY / TIMELINE Doing well , perhaps gaining some weight Had an episode of diarrhoea - DIET Inner wolf beef 500g Quinoa cooked 150gram daily Omega 3 oil NAS TREATS / CHEWS / SNACKS Liver treat 50 grams daily SUPPLEMENTS Multiviatmain - 2 tab daily MEDICATIONS / HERBS / TOPICAL PRODUCTS ENVIRONMENT / EXPOSURES LABEL / SAMPLE / RAC STATUS Label review: Awaiting review Physical sample: Bring physical label/sample required RAC sample: RAC sample pending Clinic notes: