Weekly Monitoring: Dermatologic (i.e. Skin) Signs - University of Georgia College of Veterinary MedicineUniversity of Georgia College of Veterinary Medicine

University of Georgia

Owner's Name(Required)

First Last

Your Pet's Name(Required)

Patient Number

Please include information on all of your pet’s skin signs for all days of the week.

NOTE: If your pet does not normally experience a particular sign, please skip that sign and move on to the next sign that your pet experiences (e.g. if you pet does not regularly have ear infections, skip entering information for that field).

Start Date(Required)

End Date(Required)

Day 1

Itch Scores

Ear Infections

Paw licking/chewing

Red/pink skin

New lesions on the skin (e.g. pimples, sores, hot spots, etc.)

Day 2

Itch Scores

Ear Infections

Paw licking/chewing

Red/pink skin

New lesions on the skin (e.g. pimples, sores, hot spots, etc.)

Day 3

Itch Scores

Ear Infections

Paw licking/chewing

Red/pink skin

New lesions on the skin (e.g. pimples, sores, hot spots, etc.)

Day 4

Itch Scores

Ear Infections

Paw licking/chewing

Red/pink skin

New lesions on the skin (e.g. pimples, sores, hot spots, etc.)

Day 5

Itch Scores

Ear Infections

Paw licking/chewing

Red/pink skin

New lesions on the skin (e.g. pimples, sores, hot spots, etc.)

Day 6

Itch Scores

Ear Infections

Paw licking/chewing

Red/pink skin

New lesions on the skin (e.g. pimples, sores, hot spots, etc.)

Day 7

Itch Scores

Ear Infections

Paw licking/chewing

Red/pink skin

New lesions on the skin (e.g. pimples, sores, hot spots, etc.)

Additional Information

Please add any additional details about your pet’s GI signs that you feel are pertinent:

When was your pet’s last skin/ear check with your veterinarian or dermatologist?

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