Contact Dr Peter | Home Vet Service

Enquiry Form

Please fill out the form below with your enquiry.

Note: In case of an emergency, please refer to your local emergency contacts here.

Palliative Care Form

Please fill out the form below if requested.

Owner Name
Mobile Number
Street Address
Suburb
Postcode
Pet's Name
Breed
Sex
- Male
- Female
Spayed/Neutered
- Yes
- No
Date of Birth
MM slash DD slash YYYY
Approximate Weight
Reason for Palliative Care Consultation
Primary Care Veterinarian
Primary Care Veterinarian Phone Number
Are there any other veterinary providers that have seen your pet in the last 2 years?
Home Vet Service will contact relevant veterinary providers to provide updates and also to request appropriate history of your pets condition including results and treatments.
Who referred you to Home Vet Service?
What symptoms does your pet currently have?
When did you first observe these symptoms?
Has your pet been diagnosed with a particular condition? If so please list.
What treatment is your pet currently receiving or has received?
What has the response to the treatment been?
What medication is your pet currently on? (Please include all medications or supplements your pet is currently receiving as well as the dose and frequency):
Has your pet had any reactions to medications in the past?
What is your pet’s appetite like?
What are your expectations regarding your pet’s palliative care?
What are your main concerns regarding your pet at this moment and what concerns do you have in moving forward with in home palliative care?
Anything else you would like to communicate?