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Expert Insights

Name

Animal Name, ID or Tag Number

Farm Address/ Location

Species/Breed*

Age

Sex

Male

Female

Weight

Number of animals or birds on Farm

Complaint

Onset of symptoms

Acute

Chronic

Recurrent

Duration of symptoms

Any similar problem in Past

Yes

No

If Yes, describe

Has there been a change in feed, water, or housing recently?

Is this issue affecting multiple animals

Yes

No

If yes, how many animals are affected?

Has there been any history of disease outbreaks in the past?

Yes

No

Any recent new introductions to the herd?

Yes

No

If yes, date of introduction

Multiple choice

Option 1

Option 2

If yes, please describe:

Vaccination Status

Up to date

Not up to date

Not Known

Last Vaccination date

Vaccines Administered

Current Feed Type

Short answer

Any recent changes in feed?

Yes

No

Water Source

Well

River

Municipal

Other: __________

Water Quality?

Clean

Cloudy

Contaminated

Supplementation Provided

Yes

No

If yes, Name

Housing Type

Open

Shed

Controlled environment

Bedding Used

Ventilation System

Natural

Mechanical

None

Manure Management

Regular

Infrequent

None

Have you treated the animal(s) before?

Yes

No

If yes, list treatments and medications used: _________

Response to Previous Treatment

Improved

Worsened

No Change

Have any laboratory tests been conducted?

Yes

No

If yes, list tests and Results

Have any imaging or diagnostic procedures been conducted?

Yes

No

If yes, list procedures

Recent Weather Conditions

Hot and Dry

Cold

Rainy

Humid

Any contact with wildlife or other farm animals?

Yes

No

Pests observed ticks, flies, etc.):

ticks

flies

Rodents

Veterinarian’s Notes and Observations

Prescription Pad

History Taking Farm

History Form

Our services

At Animal Wellness Shop, our expert veterinary doctor provides online diagnostic and treatment services for your animals, birds or pets. We offer convenient and effective services, ensuring your pet's well-being from the comfort of your home. Trust us for professional and compassionate veterinary support.