Drop Off: Fecal and Urinalysis Form

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Currently On Medication?
Eating
Energy
Fecal Sample
Stools appear
Vomiting
Eating mice / birds / game?
Mucous or blood in stool?
Yes No Exposed to river / pond water?
Recently eat something unusual?
Accidents in the house?
Urine Sample
Urinating in peculiar places?
Pain when urinating?
Increased frequency of urination?
Straining while urinating?
Increased volume of urine?
Blood in urine?