Client Name:

Pet Name:

Phone:

Date:

Time:

Describe your pet's symptoms. (Mark all that apply)

If you clicked "None of the above", please describe symptoms or reason for specimen drop off below:

If your pet is vomiting, did it start before or after diarrhea?

When did symptoms start?

When was the sample collected?

Was the sample refrigerated?

Describe your pets appetite:

Has there been a recent diet change?

Has your pet gotten into the trash or anything outside?

How often does your pet need to defecate?

What medications/supplements is your pet currently taking?

Has your pet been anywhere other than home recently? (dog park, family trip, hiking, swimming, beach?)

Stool grading scale: (1 being hard/dry, 7 being watery/soupy) If unsure, click "Fecal Scoring Sheet" button to look at a chart.