Pre-Visit Questionnaire

Date: *

Your Name *

First

Last

Pet's Name: *

Email *

Phone

As a Fear Free practice, we want to make your pet’s veterinary experience as enjoyable and as stress free as possible. As such, it’s important for us to understand what your pet might find upsetting. The information below will help us to adjust our plan of care to better serve and comfort your pet. Please answer the following questions to the best of your ability so we can take into consideration both your & your pet’s preterences.

Does your pet show any reluctance to getting into the car or carrier?

Yes
No

How and where does your pet travel in the car? (carrier, seatbelt, loose, etc):

During travel to the veterinary clinic, does your pet do any of the following (please check all that apply):

If Other, please explain:

Check any situations listed below that your pet has shown avoidance or dislike of in the past. You can add additional comments at the end.

Additional Comments:

How would you describe your pet around other animals and people?

Does your pet have any sensitive areas that they do not like to have touched by you or others?

Are there any procedures your pet has not liked having performed at the veterinary clinic in the past or that seemed difficult for you or the staff to do? (nail trims, temperature, ear exam, blood draw) If so, how did your pet react?

What are your pet’s favorite treats? (Please feel free to bring some with you to your visit):

Does your pet like to play with toys? If so, what kinds?

Has your pet ever been prescribed supplements and/or medications to help with a visit to the veterinary hospital? If so, what was it and what sort of results did you experience?

Is there anything else you would like us to know?

Please complete this questionnaire prior to your visit.