Lameness/Limping Form

Does the pad of the paw appear to be cracked or bleeding? *

Yes

No

Phone: *

How long has your pet been lame or had a limp? *

Is the lameness/limp worse at a certain time of day (first thing in the morning, after exercise, after rest, etc.)? *

Pet's name: *

Is your pet weight-bearing or unable to walk? *

Weight-bearing

Unable to walk

If yes, what is the time and date?

Is your pet on any medications or joint supplements? *

Yes

No

Which leg is affected? *

Name: *

If yes, what are they and how often are they given?

Do you already have an appointment scheduled? *

Yes

No

Did an injury occur? *

Yes

No

Not sure

Have you rested your pet? If so, how? (crate, no walks, etc.) *

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