Current Patient Recheck Form Current Patient-Doctor Recheck Please complete and return this form within 24 hours prior to your recheck with the doctor. DatePlease enter today's date MM slash DD slash YYYY Your name* First Last Your Pet's Name* First How is your pet doing at home (Please choose one): Walking normally, without limping Mild limping, intermittently Mild limping, consistently Moderate limping; using the leg with about 50% normal weight bearing Not using the leg when walking to slight “toe-touching” only How many times a day are you walking your pet, and for how long?What other activity/exercises are you doing?What medications and supplements are your dog taking? Please include dose, frequency and if you need any refills.*(Please note: Refills are at the discretion of the doctor)Do you have any other concerns for the doctor to address?
