Pet medical history for a new vet

VCA Animal Hospitals’ guide to sharing records lists drug and food allergies, vaccine reactions, how your pet responded to anesthesia or sedation, and handling preferences, such as a fear of men or a need for sedation before some procedures.¹ These are hard to remember accurately in the room, so put them at the top. The FDA’s page on medication errors also says to tell the vet about any medication that caused problems before, and about serious or ongoing conditions.²

Zoetis Petcare’s vet visit guide suggests listing surgeries and procedures, and giving the new clinic your previous vet’s contact details in case it needs more.³ Ask the old clinic to send its record as well. The Atlantic Veterinary College’s teaching hospital asks for records from every clinic that saw your pet for the current problem.⁴ How that works is in Share or transfer pet records to a vet. Why each line names its source and date is in What to include in a pet health record.

Example notes for Luna. Each line says where the fact came from. The recent change is not written as if it were a diagnosis.

Use the lines that apply. Attach the original clinic papers instead of retyping them.

PET
Name:
Species and breed:
Birth date or estimated age:
Sex, and spayed or neutered:
Microchip number:

ALLERGIES AND REACTIONS
Medication:
Food:
Vaccine:
Anesthesia or sedation:

CURRENT MEDICATION AND SUPPLEMENTS
Copied from labels (attach photos):
Last dose given:

PAST CARE
Procedures or hospital stays, with dates:
Ongoing conditions from clinic records:
Vaccination certificates attached:

HANDLING
What helps at the clinic:

THIS VISIT
Reason, in one sentence:
What changed, and when first noticed:
Source of each line (owner or clinic, and date):

CLINICS
Previous clinic and phone:
Records requested on:
Emergency clinic: