New Client Questionnaire

Welcome to the Veterinary Dermatologist Specialists family!

Please complete the questionnaire online below, it helps us help your pet.

Or, if you prefer, download the PDF version and email completed form to

Has your pet had an anaphylactic reaction to bee/wasp venom?

Is your pet itchy?

If you answered yes, does your pet scratch, lick chew or rub any of the following areas? Please tick all that apply:

Is this problem seasonal?

If you answer YES to being seasonal, which seasons?

Are there any other pets in the household?

Are symptoms any worse when:

Any other animals in the household affected?

Are any humans in the household affected?

Do any of the parents or siblings have a skin issues

Does your pet shake its head frequently?

Is there odour coming from the ears?

Is there discharge coming from the ears?

Is there hearing loss?

Is your pet taking any medications currently?

Has your pet had any adverse drug or vaccination reactions before?

Do you use routine flea control for your pet?

Has your pet been on a food trial?

Has your pet had any previous illness, surgery or trauma

Does your pet do exhibit any of the following?

Can we take photos of your pet and use them on our social media, website or for teaching?

Do you or your pet have an Instagram account we can follow?

How did you hear about us?

What day would you like to visit our clinic?

What time of day do you prefer?