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Initial Patient Questionnaire

Thank you for your interest in Traditional Chinese Veterinary Medicine for your pet! I am pleased to offer this service to pets in the low country. Below is some information to complete and submit prior to your pet’s appointment.

Please note: Your pet’s medical records and this form must be submitted 48 Hours Prior to scheduled consultation and treatment. Please send medical records to [email protected].

  • Clinical Signs Survey

    Please answer the following questions about your pet to the best of your ability.
  • Pet Personality/ Constitution

    The 5 Element Theory is a fundamental part of TCVM and organizes natural processes into the following components: Fire, Earth, Metal, Water, and Wood. Check all the boxes that apply to your pet's personality and health:
  • Fire Constitution

  • Earth Constitution

  • Metal

  • Water

  • Wood