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

Do any of your pet's parents/siblings have similar issues?

Does your pet scratch/lick/chew or rub at their skin?

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?

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 exhibit any of the following?

Is your pet insured?

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

Do you or your pet have social media accounts we can that you'd like us to share posts to / follow?

How did you hear about us?

What day would you like to visit our clinic?

What time of day do you prefer?