Pet Medical History & Intake Form
A medical history template — conditions, medication, vaccinations and diet captured, so the vet has your pet’s full picture before treating.
Description
Form fields
Everything the Pet Medical History & Intake Form above collects — 13 fields across 2 pages, so you can see exactly what it captures before you make it your own.
Your Pet's Medical History
Pet's name
Short Answer
Species
Dropdown
Current conditions & medication (name, dose, frequency)
Long Answer
Known allergies or reactions (incl. to medication/anaesthetic)
Long Answer
Previous illnesses or surgeries
Long Answer
Vaccinations up to date?
Yes/No
Last flea / worm treatment
Date
Diet & approximate weight
Long Answer
Reproductive status
Dropdown
Your details
Your name
Name
Contact number
Telephone
Email address

Accurate history
Consent
No credit card
Unlimited forms
Unlimited results
Template FAQs
Common questions about the Pet Medical History & Intake Form — what it captures, when to use it, and how to make it your own.
Why does the vet need my pet's full medical history?
Because past conditions, reactions and treatments shape safe care today — a drug allergy, a heart murmur, a previous operation all matter. A complete history lets the vet treat your pet safely and spot patterns.
What does the intake cover?
Current and past conditions, medication and doses, allergies or reactions, previous surgeries, vaccination and parasite-treatment status, diet and weight, and reproductive status — the full clinical picture.
Why do allergies and reactions matter so much?
Because a reaction to a medication or anaesthetic can be serious. Recording known allergies and past reactions means the vet avoids them and keeps your pet safe during treatment.
Should I include diet and weight?
Yes — diet and weight affect health and influence drug doses and treatment plans. They’re a genuine part of your pet’s medical picture, not an afterthought.
What if I don't know all my pet's history?
Share what you can — especially for rescues, full history isn’t always available. The vet works with what’s known and can request records from a previous practice to fill gaps.
Is the intake form free?
Yes — free with a Fun Forms account, fully customisable, and ready to embed or share as a link.
No credit card
Unlimited forms
Unlimited results







