Please fill out as thoroughly as possible so that an Iv San Bernard consultant can best assist you in creating a skin therapy plan. For best help, please include several well-lit photos of affected areas.

    Owner / Groomer Information



    Pet Information

    Pet Name


    Which other species is it?

    Pet Age:


    Issue description

    Please describe issue in detail:
    How long has this been going on?

    Check all that apply:

    Please describe odor:

    Specify "other":

    Please attach full body and close-up photos of the skin.

    Medical Information

    Has the pet seen a vet?

    Has bloodwork been done recently?

    What was the diagnosis?

    Is the pet on any prescriptions?

    Which ones?

    Has the pet been diagnosed with any other chronic issue, even if believed to be unrelated?

    Please describe