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Our Edwards Office is Open Tuesday, Wednesday and Thursday
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Monday - Friday: 8:00am - 5:30pm
(970) 328-5444
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Drop Off: Fecal and Urinalysis Form
First Client Name
Last Client Name
Pet's Name
Phone
Time sample was obtained
*
1st Check
Recheck
Wellness
Days Abnormal
Currently On Medication?
Yes
No
What are you currently feeding your pet?
Any recent changes in food or snacks?
Eating
Less
More
Normal
Energy
Down
Normal
Comments / Concerns
Fecal Sample
Stools appear
Firm
Soft
Runny
Vomiting
Yes
No
Eating mice / birds / game?
Yes
No
Mucous or blood in stool?
Yes
No
Yes No Exposed to river / pond water?
Yes
No
Recently eat something unusual?
Yes
No
Accidents in the house?
Yes
No
Urine Sample
Urinating in peculiar places?
Yes
No
Pain when urinating?
Yes
No
Increased frequency of urination?
Yes
No
Straining while urinating?
Yes
No
Increased volume of urine?
Yes
No
Blood in urine?
Yes
No
