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 Date Format: MM slash DD slash YYYY Your name* First Last Your Pet's Name* First Last How is your pet doing at home (Please choose one):Walking normally, without limpingMild limping, intermittentlyMild limping, consistentlyModerate limping; using the leg with about 50% normal weight bearingNot using the leg when walking to slight “toe-touching” onlyHow 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 and frequency.Do you need any refills? Which medication?*(Please note: Refills are at the discretion of the doctor)Do you have any other concerns for the doctor to address?
