Welcome to Westway Animal Clinic. Our approach with Traditional Chinese Veterinary Medicine involves understanding, as best as we can, what you and your pet have already been through. It is important to us to take a thorough history so that we can customize an approach for you. Rather than spend time during your appointment going through these details, we feel it is important that you can answer our questions from the comfort of your own home, at your own pace. Please complete the form to the best of your ability, we’ll take it from there…

Alternative Medicine Patient History
Daytime Phone Number
Evening Phone Number
Did symptoms change over time? *
Does your pet have difficulty falling asleep?
Does your pet have trouble staying asleep?
Is your pet dreaming during sleep?
How is your pet's energy or stamina?
Where does your pet prefer to sleep?
When not sleeping, which does your pet prefer?
Does your pet travel to different cities/countries?
Has your pet been previously diagnosed with any medical conditions by a veterinarian?
Has your pet received any previous treatments/medications?
What are the main health problems that your pet is currently experiencing? Please select all that apply. *
How long has the current problem been present?
What conditions cause the problem to worsen?
Has your pet demonstrated any behavior changes recently? Please select all that apply.
What medications and therapies are administered to your pet currently? Please select all that apply.
What kinds of foods make up your pet's diet?
What type of food does your pet prefer?
How does your pet perform during exercise?
How would you describe your pet's personality? Choose the Element that most closely applies. *