Client Discharge Form

Dear (enter Client’s Name),

Your pet, (enter Pet Name), has been diagnosed with diabetes. As we discussed, your pet will need life-long treatment with Vetsulin^® (porcine insulin zinc suspension).

Administering Vetsulin

Please give ( Pet Name ‘X’ ) units of insulin.

Select Frequency (enter number of units):

Select additional information to include from the list below:

Feeding Your Dog

(Pet Name ) must be fed (‘X’ ) times a day.

Select additional dog information to include from the list below:

For dogs on once-daily administration of Vetsulin:

For dogs on twice-daily administration of Vetsulin:

Feeding Your Cat

Select additional cat information to include from the list below:

Exercise

It is important for (Pet’s Name ) to exercise.

Select additional dog information to include from the list below:

Monitoring Your Pet

Your observation of the below can be very helpful for treatment success:

Select additional dog information to include from the list below:

Select to add the (number of ) times a day your pet urinates.

Please select the additional content that should be included with this item (choose all that apply ):

Select to add checking your pet’s blood glucose (number of ) times a day.

Please select the additional content that should be included with this item (choose all that apply ):

Reevaluation of Your Pet

(Pet’s Name ) will need to be reevaluated in (‘X’ days/weeks/months ); please schedule an appointment.
Please call our hospital if you have any problems or questions.

Please select days, weeks, or months:

Create Discharge Form

Once you have finished entering your information and making your content selections, click the ‘Create Discharge Form’ button to view your customized client discharge form.