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Quality Care Preventative Care Professional Care Empowering Care
Thank you for contacting us! If needed, you will hear back within 48-72 hours.
Which seems to motivate your pet the most?
Food
Toys
Neither
Which does your pet prefer to interact with?
Females
Males
Neither
Are there any procedures your pet has not liked having performed at the veterinary clinic such as nail trims, temperature, blood draws or vaccines
How would you describe your pet around other animals and people?
Name:
*
Do you have difficulty loading your pet into a car or carrier?
YES
NO
The intent of this questionaire is to help us make your pet as comfortable as possible. Please add any additional info you think is important.
Does your pet have any sensitive areas they do not like to have touched?
While in the car does your pet exhibit any of the following?
Vomiting
Drooling
Hides
Excited
Urinates
Defecates
Vocalizes
Pants
Shivers
Paces
Other
Pet Name
*
Does your pet have issues with any of the following?
Entering Veterinary Clinic
Other animals or pets passing by while in veterinary clinic.
Waiting with other pets/humans in the waiting area
Being approached by veterinary staff
Stepping on to scale for weighing
Noises such as phones, door bells, intercoms
Noises coming from other rooms (doors open/closing, talking)
Walking into an exam room
Being lifted onto a table for exams and sample collection
Loud voices
Having rectal temperature taken
Having direct eye contact with staff
Use of instruments such as stethoscope, thermometers, ear speculums
Where and how does your pet ride in the car?
Please remember to bring all of the following
Has your pet been prescribed any medications to help with veterinary visits? If yes please list.
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