Pre-Visit Questionnaire

Form
Pre-Visit Questionnaire

As a Fear Free Professional team, we want to make your pet's veterinary experience as enjoyable and stress-free as possible. As such, it's important for us to understand what your pet might find upsetting. This information will help us to adjust and better serve and comfort your pet. Please answer the following questions to the best for you ability so we can take into consideration both you and your pet's preferences.
Name *

First Name Last Name
Pet's Name *
Does your pet show any reluctance to getting into a carrier or car?

Yes No
How and where does your pet travel in the car?
During travel to the veterinary hospital, does your pet do any of the following:

Eager & Excited Subdued Reluctant Bark/Meow Hide Whine Drool Pant Vomit Tremble Urine/BM Pace Other
Does your pet prefer:

Female veterinary professional Male veterinary professional It doesn't matter
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

Getting in the carrier or car Entering the veterinary hospital Other pets and/or people passing by while in reception/check-in Waiting with other people/animals in the waiting area Being approached by veterinary staff Getting on the scale Hearing the doorbell, overheard intercom or phones ringing Sounds coming from the back areas of the practice Going into the exam room Being put up on the table for examination Having direct eye contact with the technician and/or veterinarian Loud voices during the examination Having a rectal temperature taken The use of instruments, such as the stethoscope or otoscope Being taken out of the exam room for procedures
How would you describe your pet around other animals and people
Does your pet have any sensitive areas that he/she does not like to have touched by your or others?
Are there any procedures your pet has not liked having performed at the veterinary hospital in the past or that seemed difficult for you or the staff to do? (Nail trim, weight, temperature, etc)
What are your pet's favorite treats? (Please bring some to your next visit!)
Does your pet like to play with toys? If so, what kinds?
Has your pet ever been prescribed any supplements 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 about your pet that you would like us to know?
Should be Empty:

Form

Pre-Visit Questionnaire