Concerns or Update with Treatment Plan

Please use this form if your pet is experiencing any adverse effects with their treatment plan, or if an update was requested. Please note that some questions or concerns cannot be managed remotely and a recheck exam might be necessary in order to provide the best care for your pet.

We will get back to you within 1-3 business days by email or phone if necessary.

IF THIS IS AN EMERGENCY, PLEASE CONTACT YOUR FAMILY VETERINARIAN OR SEEK URGENT VETERINARY CARE.

Please note to receive medical advice for your concern, your pet must have had a recheck with VADER Clinic within the last year. If your pet has not had a recheck within the past 12 months, please call us at 519-821-7546 to schedule an appointment.

Last Name

First Name

Pet's Name

Secondary Last Name (that your pet may be listed under)

Phone

(###)

###

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What is your reason for providing an update?

I have been asked to provide an update

I have a question about my pet's treatment plan

My pet is experiencing an adverse reaction

My pet is not responding to the treatment plan

What medications and/or topicals is your pet currently receiving?

Please include all medications, supplements, topicals (e.g. shampoo, sprays, wipes, creams, ear drops), along with their strengths and how often you are giving them. In dermatology, medications are often prescribed with tapering doses and it is not always clear where a pet is on a tapering protocol. Please do not list "as prescribed".

What diet is your pet currently eating?

Please include any treats and pill pockets

Please provide your update or concern

If relevant, include: When the signs started The area(s) of focus Any gastrointestinal issues (e.g vomiting, diarrhea)

Current Itch Level

0 = Not Itchy, 1-2 = Very Mild Itch, 3-4 = Mild Itch (more frequent), 5-6 = Moderate Itch (regular episodes), 7-8 = Severe Itch (prolonged), 9-10 = Extremely Itchy (continuous, unable to rest).