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Cedar Creek/Intake/Bella · Coleman

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Sample intake — Bella (Golden Retriever) · 9:30 AM annual exam

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PT-3201 · Dog · Golden Retriever · 9:30 AM

Bella · 4 yr · 62 lb

Owner: Sarah Coleman·Submitted Apr 30, 2026 at 7:42 AM·Intake complete

Owner contact

Address412 Linden Ridge, Brooklyn, NY 11215
Phone+1 (917) 555-0193
Emailsarah.coleman@gmail.com
Emergency contactMarcus Coleman · spouse · +1 (917) 555-0188
Preferred pharmacyWedgewood compounding (vet specialty)

Vaccine history

VaccineLast givenNext dueStatus
DA2PPApr 14, 2025Apr 14, 2026 (today)Booster today
Rabies (3-year)Mar 22, 2024Mar 22, 2027Current
BordetellaAug 02, 2025Aug 02, 2026Current
LeptospirosisApr 14, 2025Apr 14, 2026 (today)Booster today
Lyme (4Dx)Apr 14, 2025Apr 14, 2026 (today)Booster today

Medical history

  • Spayed Aug 2022 (Cedar Creek)
  • Mild seasonal allergies · responsive to Apoquel PRN
  • ACL strain 2024 · resolved with rest + carprofen course

Current medications

MedicationScheduleSince
Heartgard Plus 51-100lbMonthly2022
Bravecto 88-123lbEvery 12 weeks2022
Apoquel 16mgPRN spring/fall2024

Allergies & sensitivities

SubstanceSeverityReaction
Suspected pollenmildpaw chewing, ear scratching

Pet profile

Microchip956000 010 412 882
SexFemale · spayed
ColorCream + light gold
Rabies tagNY-2026-44782 · expires 03/2027
DietRoyal Canin Adult Golden · 2 cups twice daily

Behavior notes

Friendly with strangers. Anxious during nail trims · Fear-Free certified handling preferred.

Consents signed

  • Treatment consent

    Signed Apr 30, 7:40 AM

  • Anesthesia release (future use)

    Signed Apr 30, 7:41 AM

  • Photography for medical record

    Signed Apr 30, 7:41 AM

  • Financial responsibility

    Signed Apr 30, 7:42 AM

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