---
title: Pet Geriatric Screening Package Form Template for Veterinary Clinics | Paperform
description: Comprehensive senior pet health screening form for veterinary practices. Collect health histories, assess cognitive function, recommend diagnostics, and process payments for geriatric pet care packages.
url: "https://paperform.co/templates/pet-geriatric-screening-package-form"
type: static
generatedAt: "2026-03-28T00:44:47.018Z"
---

[← Back to free form templates](/templates/)    ![Pet Geriatric Screening Package Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/pet-geriatric-screening-package-form.png)
    [Preview](https://_preview.paperform.co/ai-template/pet-geriatric-screening-package-form) [Use this template for free](/create?ai-template=pet-geriatric-screening-package-form)    [Industry-Specific Forms](/templates/category/industry-specific/) [Healthcare](/templates/industry/healthcare/)[Veterinary & Animal Care](/templates/industry/veterinary/) [Veterinarian](/templates/role/veterinarian/)     About this free form template
### Complete Senior Pet Care Assessment Made Simple

As our beloved pets age, they need specialized care and attention to maintain their quality of life. Just like aging humans, senior pets face unique health challenges that require proactive monitoring and early intervention. That's where a comprehensive geriatric screening package becomes essential—and with Paperform, veterinary clinics can streamline this entire process into one beautiful, efficient workflow.

#### Why Veterinary Clinics Choose This Template

This Pet Geriatric Screening Package Form is specifically designed for veterinary practices that want to deliver exceptional senior pet care while maintaining operational efficiency. Whether you're a small animal clinic, specialty veterinary practice, or mobile vet service, this template helps you collect detailed health histories, assess cognitive function, recommend age-appropriate diagnostics, and create personalized care plans—all before the appointment even begins.

The form captures everything from basic pet information and medical history to detailed behavioral assessments and specific senior health concerns. By having this information in advance, your veterinary team can prepare properly, allocate the right amount of consultation time, and ensure all necessary tests and equipment are ready when the pet arrives.

#### Streamlined Workflow That Saves Time

Time is precious in any veterinary practice. This template eliminates the clipboard and paper form routine that slows down your intake process. Pet owners can complete the comprehensive screening assessment from home on any device, giving them time to think carefully about their pet's symptoms and behaviors without feeling rushed in the waiting room.

The conditional logic built into the form means pet owners only see questions relevant to their pet's specific situation. If they indicate their senior pet is showing signs of cognitive decline, they'll see detailed behavioral assessment questions. If mobility issues are a concern, specific joint and movement questions appear. This intelligent branching creates a personalized experience while ensuring your team gets exactly the information they need.

#### Integrated Payments for Seamless Service

One of the standout features of this Paperform template is the built-in payment functionality. Senior pet screening packages often involve multiple diagnostic tests—bloodwork, urinalysis, radiographs, blood pressure monitoring—and being able to collect payment or deposits at the time of booking significantly reduces no-shows and administrative follow-up.

The form includes a product selection field where pet owners can choose their preferred geriatric screening package (basic, comprehensive, or premium) with transparent pricing for each option. They can also add recommended tests or consultations as they book. With Stripe, PayPal, or Square integration, payments are processed securely, and your clinic receives the funds directly—no manual invoicing required.

#### From Submission to Action with Stepper

Once a pet owner submits their geriatric screening form, the real magic happens with workflow automation. By connecting this Paperform template to Stepper (stepper.io), your AI-native workflow builder, you can create sophisticated multi-step processes that run automatically:

 - **Instant confirmation emails** with appointment details and pre-visit preparation instructions
 - **CRM updates** that log the new geriatric patient in your veterinary practice management software
 - **Team notifications** via Slack or email that alert veterinarians and vet techs about incoming senior patients with specific concerns
 - **Appointment scheduling** that books the appropriate time slot based on package selection
 - **Follow-up sequences** that send pre-appointment reminders, post-visit care instructions, and check-in messages
 - **Records management** that files completed forms in the correct patient folder in Google Drive or your practice management system

This level of automation means your front desk staff spend less time on administrative tasks and more time providing compassionate care to pets and their owners.

#### Built for Veterinary Professionals

This template speaks the language of veterinary medicine while remaining accessible to pet owners. The questions are structured to gather clinically relevant information about age-related conditions like arthritis, kidney disease, dental disease, cognitive dysfunction syndrome, and endocrine disorders—the conditions your team needs to screen for in senior patients.

The cognitive function assessment section uses validated behavioral markers that help identify early signs of canine or feline cognitive dysfunction. Questions about disorientation, changes in sleep-wake cycles, altered interactions, house soiling, and activity level changes give you a comprehensive picture before the clinical examination.

#### Customizable to Your Practice

While this template is comprehensive out of the box, it's also fully customizable to match your clinic's specific protocols and branding. You can adjust the screening package options and pricing, add your clinic's logo and colors, modify questions to align with your diagnostic approach, and customize the success message with your specific pre-visit instructions.

The doc-style editor makes these changes intuitive—just type, format, and adjust as if you're editing a document. No wrestling with complicated form builders or getting stuck on technical details. Your team can own this form and keep it updated as your services evolve.

#### Security and Compliance Veterinary Practices Trust

Pet health information is sensitive, and pet owners trust you to keep it secure. This Paperform template benefits from Paperform's SOC 2 Type II compliance and robust security infrastructure, giving you and your clients peace of mind. Data is encrypted in transit and at rest, and you can set custom data retention policies that align with your record-keeping requirements.

While Paperform is not HIPAA compliant (relevant for human health data), it provides the security controls that veterinary practices need to protect pet health information and client data responsibly.

#### Who This Template Is Perfect For

This Pet Geriatric Screening Package Form is ideal for:

 - **Small animal veterinary clinics** looking to formalize their senior pet care programs
 - **Specialty veterinary practices** that focus on geriatric animal medicine
 - **Mobile veterinary services** that need thorough pre-visit assessments
 - **Veterinary hospitals** implementing wellness programs for aging pets
 - **Holistic and integrative vet practices** that take a comprehensive approach to senior care

#### Get Started in Minutes

With over 30,000 professionally designed templates, Paperform makes it easy for veterinary professionals to create forms that look great and work even better. This geriatric screening template is ready to use immediately—just customize with your clinic's details, connect your payment processor, and share the link with your clients.

Your senior pet patients deserve the best care possible, and their owners deserve a smooth, professional experience from first contact through follow-up. This template delivers both, helping you build stronger relationships with your clients while providing exceptional medical care to their aging companions.

Start using this template today and transform how your veterinary practice delivers senior pet care—because every golden-year pet deserves a comprehensive, compassionate approach to their health and wellbeing.
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