Now Serving South Bay

At-Home Medical Inquiry (AMI) Questionnaire

To ensure that at-home veterinary care is the safest and most effective option for your pet, we ask clients to complete this brief questionnaire before scheduling certain visits.

Your responses will help us determine whether your pet’s condition can be addressed in a home setting or if a referral to a full-service hospital or emergency facility is more appropriate.

Please answer all questions as accurately as possible. Once submitted, our team will review your responses and follow up with care recommendations.

If you’re unsure how to answer a question, we’re happy to help — call us at (619) 356-8244.

Get Started

Please Fill the (AMI) Questionnaire Form Below

Owner Information

Patient Information

Reason for Visit

Review of Body Systems

General
Lethargy or any change in activity level?
Significant weight loss or gain?
Change in attitude, anxiety, or unusual posture. Please also list any fear or aggression during vet visits.
Gastrointestinal
Is it normal, reduced, or increased?
Any recent changes in food, treats, or access to trash.
Possibility of having eaten a toy, string, or other non-food item.
Any chance the pet accessed toxins, pesticides, rodent killer, prescription medications, or known toxic foods. 
Respiratory
Any difficulty breathing or increased breathing effort.
Urinary
Skin and Musculoskeletal
Does the pet seem painful?
Neurological
History of seizures, including frequency and duration.
Any issues with walking, balance, or running.
Lifestyle and Exposure History
Is the pet exclusively indoors, outdoors, or both?
Exposure to other animals at dog parks, boarding, or grooming.
Any recent travel to other states or countries.
Are other animals in the household sick?
Medication and Supplement History
List all current medications, supplements, and preventatives (e.g., heartworm, flea/tick).
Note any known allergies or adverse reactions to medications.