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Canine Risk Assessment Form

Village Square Veterinary Clinic

Canine Vaccination Risk Assessment

The Village Square Veterinary Clinic uses this Risk Assessment to determine which vaccinations your pet should receive. It is not our belief that every animal needs to receive vaccinations for every disease if their lifestyle does not put them at risk for those diseases. Please answer every question to help us provide the best possible protection for your pet. Should you have any questions, please do not hesitate to ask.. Does your dog:

Go to dog parks?
Swim in lakes, ponds or canals?
Go to a groomer and stay for any period of time?
Visit other dogs either at your home or someone else’s?
Urinate/defecate on paper?
Participate in activities where they come in contact with other animals? (i.e. showing or breeding)
Have a history of any serious illness? If yes, what?
Have a history of any kind of reaction to vaccines? If so, what kind?
Have access to food/water outside where other animals do too?
Do you have contact with other animals with or without your pet?
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