Holistic Questionnaire
Pet's name
First Name
Last Name
Pet's energy level?
Low
Medium
High
Pet prefer's warmth or cold?
Warmth/Sunlight
Cold/Cool floor
Major issues and how long?
Thirst Level
Very thirsty
Normal
Less Thirsty
Appetite
Ravenous
Normal
Finicky
Feces
Dry
Bloody
Stinky
Normal
Loose
Urine
Short stream
Bloody
Stinky
Normal
Long stream/Leakage
Sex of Pet
Female Spayed
Male Neutered
Female Intact
Male Intact
Feline or Canine
Feline
Canine
Age/Date of Birth
Food Allergies
Weight History
Supplements
Medication
Current Diet/Food Given
Please choose the one that best applies to your pet
Earth: Relaxed, Laid back, Motherly, loyal, Friendly GI Issues, Sweet &Kind, Tolerant.
Metal: Loves Order, Obeys the Rules, Aloof, Disciplined Attitude, Good haircoat, Independent, shy, Skin or Lung issues
Wood: Competitive, Assertive, Confident, Strong, Impulsive, Athletic Stamina, Bossy, Eye or Ear Issues.
Fire: Hyper/Easily excited, noisy/barks a lot, affectionate, loves to be petted, center of the party, separation anxiety,heart issues, sensitive, greets quickly and warmly.
Water: Careful, Curious, self contained, likes to hide, meditative, slow and consistent, shy/fearful, urinary issues.
Preview PDF
Submit
Should be Empty: