Vitality Pet Care- Homeopathic Progress Report

HOMEOPATHIC PROGRESS REPORT

- Required Field

Owner:

Owner Email:

You will receive a copy of the submitted form at this email address if entered.

Pet:

Date of Administration:

Remedy:

Only indicate symptoms that have CHANGED since the remedy administration.

OVERALL
Compared to prior to the remedy, my pet is:

APPETITE
Increased? Decreased? Types of food favored? What time of day is the appetite different?

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WATER CONSUMPTION
Increased? Decreased? Small frequent sips? Large single drink? Specific time of day?

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VOMITING
Frequency? Describe Odor? Color? Foamy? Clear? Food?

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STOOL
Soft? Watery? Blood? Mucus? Color? Increased frequency? Time of day?

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URINATION
Increased frequency during the day? Multiple efforts with each elimination? Straining? Smaller/larger amounts? Odor? Color? Blood tinge or drops of blood? Vocalizing with urination?

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BREATH
Foul? Sour? Putrid? Offensive?

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GINGIVA(GUMS)
Color-pink,red,yellow? Moist or Tacky? Red line along teeth?

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ITCHING
Is it present? Does it change in severity? Does is change in location? Does it occur at a specific time of day or night?

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LESIONS ON SKIN
Size? Shape? Crusty? Discharging? Scab adherent? Discharge under scab?

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EARS
Redness? Discharge? Color of discharge? Lesions? Odor?

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EYES
Redness? Discharge? Color of discharge? Swelling of lids or conjunctiva? Cloudy corneas? Lesions on corneas? Are the whites of the eyes yellow? Squinting of one or both eyes?

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SIGNS OF DISCHARGE
If so, what color & texture? Is the underlying skin red/inflamed?

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BEHAVIORS
Withdrawn? Needy? Changes in preferences of sleeping places?

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ANY FURTHER SYMPTON(S) NOT LISTED ABOVE?

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Comments:

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