Are you the pet’s Owner or Groomer? —Please choose an option— Owner Groomer
Do you already have or use any Iv San Bernard products? —Please choose an option— Yes No
Pet Information
Pet Name
Gender:Intact Male Intact Female Spayed Female Neutered Male
Species:Dog Cat Horse Other
Breed:
Pet’s current diet (please include any treats/supplements and if there have been any recent
Is the pet on flea/tick medication? If so, what brand and type (oral, topical,
What is the pet’s current bathing routine? (frequency and products used):
Issue description
Please describe issue in detail:
Is this a seasonal issue?Yes No
Check all that apply:Crusty Oozy Inflamed Sores Itchy Odor Hair loss Dry/Flaky Other
Please attach full body and close-up photos of the skin (max 3 photos).
Allow our staff to use pictures for educational purposesYes No
Medical Information
Has this pet been seen by a vet for this issue?Yes No
Is the pet being actively treated by a veterinarian for this issue?Yes No
Has bloodwork been done recently?Yes No
Has the pet been seen by a specialist/Dermatologist?Yes No
Is the pet on any medications unrelated to this issue?Yes No
Has the pet been diagnosed with any other chronic issue, even if believed to be unrelated?Yes No
Disclaimer: This consultation form is intended for informational purposes only and does not constitute a diagnosis for your pet. Its primary purpose is to assist in formulating a plan of action based on the information provided. Please be aware that the accuracy and completeness of the details shared will directly influence the effectiveness of our recommendations. There may be situations in which we advise seeking veterinary assistance or testing for a comprehensive evaluation. It is important to note that the purpose of our recommendations is to contribute to the restoration of your pet’s skin, and our suggestions should not be considered a substitute for professional veterinary care.
