Fill this before you pick up the phone. Keeps the call under 5 minutes.
Date of concern: Time noticed:
Animal tag / ID: Species / breed / age:
Current weight (est):
☐ Off feed ☐ Down / recumbent ☐ Lame ☐ Coughing ☐ Nasal discharge ☐ Diarrhea ☐ Bloody
☐ Straining ☐ Swollen joint ☐ Skin lesion ☐ Neurological ☐ Pregnancy issue ☐ Other
| Temp | Pulse | Respiration | Capillary refill | Mucous membrane color |
|---|---|---|---|---|
Signed: Date: Initials: