Dog Medical Intake Form - maddiesfund 2026

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  1. Click ‘Get Form’ to open the Dog Medical Intake Form in the editor.
  2. Begin by entering the Date of Arrival and Patient’s Name at the top of the form. Ensure that you also fill in the ID number for easy reference.
  3. In the Source section, specify where the dog is coming from. Then, indicate the dog's Sex, Weight, Breed, and Age. This information is crucial for accurate medical assessment.
  4. Fill out any additional notes regarding the dog's condition or history in the designated area. This helps veterinarians understand specific needs.
  5. Complete the vaccination details by checking off appropriate boxes for DA2PP, Bordetella, and Rabies stickers. Record dates and dosages as necessary.
  6. Document findings from the physical exam by filling out sections on attitude, hydration status, and any abnormalities observed during examination.
  7. Lastly, enter prescription details if applicable and circle any approved actions such as Surgery or Adoption before saving your completed form.

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Maddies Fund offers free consulting services to support animal shelter and foster-based organizations in improving animal well-being, decreasing length of stay and increasing live outcomes. Consultations are led by Dr. Sheila Segurson, Director of Shelter Solutions, and Kelly Duer, Senior Shelter Solutions Specialist.
Maddies Pet Assistant (MPA) is a free app developed by Maddies Fund to provide you with support after you bring a dog or cat home.

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