Online Consultation Request Form

Please be advised that some condinions require further examinations/tests that are not possible online before prescriptions can be given. If any investicative tests have been done please e-mail them to cypruluxurypets@gmail.com clearly labelled.

Pet's Name

Current Symptoms

Loss of appetite/Subdued/Weakness/Shivering

Vomiting/Diarrhoea/Coprophagia

Pain/Limping/Orthopedic

Loss of endurance/Cardiovascular

Coughing/Sneezing/Dyspnoea

Itching/Hair loss/Dermatological

Excessive Drinking/Urinating (polydypsia/polyuria)

Dental/Dysphagia (difficulty to eat)

Swelling/Mass

Eyes/Opthalmic

Other:

Give more detail

Please select

Are the symptoms

Getting worse

Improving

Not changing

Please select

If Yes, when?

Any treatment given for these symptoms?

What food is the pet currently on?

Any other comments?

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