Animal Companion Session Intake Form
For assistance email info@tammybillups.com
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code and Country
Your Animals Name and Age
*
Name
Age (best estimate if unknown)
Species
*
Animal Species (dog, cat, horse, etc.) and Breed
Male or Female?
What source brought you to Tammy's work?
*
Web search? Books? Referred from?
How and when did this wonderful animal come to be with you?
*
Are there other animals in the house? Please share pertinent details about the interaction that might be relevant to your animal's healing session.
*
Share any details you are aware of about their background that might be contributing to your animal's current day issues.
*
What are his/her physical symptoms?
*
List any medications/supplements your animal is currently taking, and its current diagnosis.
*
Does he/she have any negative behaviors? How long have these been going on?
*
Describe his/her personality.
*
What is her/his current diet?
*
Have there been any emotional changes in the home around the time of the new behavioral or physical issue? (New family member, move, loss, etc.)
*
Share your main concern or intention for what you are hoping to accomplish for your animal companion.
*
Please upload a photo of your animal companion.
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Please return to Tammy's website for payment and step-by-step session instructions. (New client page) tammybillups.com Thank you!
Submit Intake Form
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