Acupuncture New Patient Questionnaire

Before your pet's consultation, please complete our new Acupuncture patient questionnaire. This will allow the veterinarian to review their case and prepare for your first visit.

Which practice would you like to register with?

Have we seen your pet here at Bloorcourt Veterinary Clinic before?
What species is your pet?*
Is your pet spayed or neutered?*
If yes, please enter the clinic’s name, and ask them to send a copy of your pet’s records to care@bloorcourtvetclinic.com.
Has your pet shown any behavioural, personality, or temperament changes recently?*
Which of these words (if any) best describe your pet when (s)he is healthy and feeling well? (Question 1 of 5)*
Select as many words as apply to your pet.
Which of these words (if any) best describe your pet when (s)he is healthy and feeling well? (Question 2 of 5)*
Select as many words as apply to your pet.
Which of these words (if any) best describe your pet when (s)he is healthy and feeling well? (Question 3 of 5)*
Select as many words as apply to your pet.
Which of these words (if any) best describe your pet when (s)he is healthy and feeling well? (Question 4 of 5)*
Select as many words as apply to your pet.
Which of these words (if any) best describe your pet when (s)he is healthy and feeling well? (Question 5 of 5)*
Select as many words as apply to your pet.
If yes, please describe.
If yes, please describe.
If yes, please describe.
If yes, please describe.
If yes, please describe.
If yes, please describe.
If yes, please describe.
Have any diagnostic tests been performed related to your pet's current health concern?*
Security Question*

Practice information

Bloorcourt Veterinary Clinic

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  • Mon
    8:00am – 7:00pm
  • Tue
    8:00am – 7:00pm
  • Wed
    8:00am – 7:00pm
  • Thu
    8:00am – 7:00pm
  • Fri
    8:00am – 7:00pm
  • Sat
    9:00am – 3:00pm
  • Sun
    Closed (Sundays & Holidays)

After-Hours Emergencies

Please call:

416-784-4444
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Find us here:

1074 Bloor St W Toronto ON M6H 1M6
get directions with Google Maps
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For after-hours emergencies, please call:

416-784-4444