The information on this form is important in allowing us to provide a comfortable reception, appointment, and departure for your pet in order to positively embed the next visits' expectations. A true Fear Free visit begins before it starts and educates on practices to continue at home.

Name *

First

Last

Email *

Pet's Name *

How does your pet behave during travel in the car? (Check all that apply) *

Happy/Enjoys the Ride
Paces/Panting
Lays Down/Comfortable
Other

If other, please describe. *

Does your pet show any signs of nausea with car travel? *

Yes
No

If yes, please describe the signs of nausea. *

How do you describe your pet's reaction to entering the veterinary hospital? (Check all that apply) *

If other, please describe. *

What are your pet's favorite treats? (Check all that apply) *

Cheese
Peanut Butter
Store-Bought Treats
Other

If store-bought or other, please describe your pet's preferred treats. *

Does your pet enjoy getting on the scale for weight measurement? *

Yes
No

Does your pet have any sensitive areas where he/she does not like to be touched or examined by you or others? (Check all that apply) *

If other, please describe. *

How does your pet react to exiting the hospital? *

Happy/Enjoys Leaving
Reluctant to Leave
No Preference

How does your pet behave upon re-entering the home and/or upon re-introduction to home with other pets? (Check all that apply) *

Happy/Smooth Return
Hides
Other pet(s) will not leave him/her alone
Other

If other, please describe. *

Please share any additional information you would like us to know (i.e. allergies, preference to males or females, comforting or favorite areas to pet, does better with mom/dad in/out of the room, etc.) *

Pre-Visit Questionnaire Form

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