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Pre-Visit Questionnaire
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1
What is your pet's name?
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2
Please select your location from the list below
ACT & Surrounds
NSW (excluding northern NSW)
QLD (and northern NSW)
SA
VIC
WA
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3
Please select the veterinarian that is coming to assist with your pet's farewell from the list below
Please Select
Dr Justin Michaels
Dr Louise Grey
Dr Tim White
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Please Select
Dr Justin Michaels
Dr Louise Grey
Dr Tim White
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4
Please select the veterinarian that is coming to assist with your pet's farewell from the list below
Please Select
Dr Abby Masters
Dr Ainslie
Dr Adele Lloyd
Dr Aziz
Dr Caitlin Stachovski
Dr Cassandra
Dr Claire Fu
Dr Duncan Houston
Dr Gen Dwyer
Dr Janessa Lim
Dr Josie Ginty
Dr Leisa Eagleton
Dr Melissa Kozaruk
Dr Sam Marzouk
Dr Sherif
Please Select
Please Select
Dr Abby Masters
Dr Ainslie
Dr Adele Lloyd
Dr Aziz
Dr Caitlin Stachovski
Dr Cassandra
Dr Claire Fu
Dr Duncan Houston
Dr Gen Dwyer
Dr Janessa Lim
Dr Josie Ginty
Dr Leisa Eagleton
Dr Melissa Kozaruk
Dr Sam Marzouk
Dr Sherif
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5
Please select the veterinarian that is coming to assist with your pet's farewell from the list below
Please Select
Dr Audrey Harvey
Dr Carly
Dr David Kahl
Dr Elnaz
Dr Emma Andrew
Dr Emily Carrico
Dr Kate
Dr Louise Kennedy
Dr Rachael Moon
Dr Sandra
Dr Sha Singh
Dr Sharmila Abbott
Dr Stu Cunningham
Dr Tom Currie
Please Select
Please Select
Dr Audrey Harvey
Dr Carly
Dr David Kahl
Dr Elnaz
Dr Emma Andrew
Dr Emily Carrico
Dr Kate
Dr Louise Kennedy
Dr Rachael Moon
Dr Sandra
Dr Sha Singh
Dr Sharmila Abbott
Dr Stu Cunningham
Dr Tom Currie
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6
Please select the veterinarian that is coming to assist with your pet's farewell from the list below
Please Select
Dr Amy Andrews
Dr Edward Gerges
Dr Gregory Wright
Dr Henriette van der Westhuizen
Dr Mac
Dr Rimon
Dr Sam Walker
Please Select
Please Select
Dr Amy Andrews
Dr Edward Gerges
Dr Gregory Wright
Dr Henriette van der Westhuizen
Dr Mac
Dr Rimon
Dr Sam Walker
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7
Please select the veterinarian that is coming to assist with your pet's farewell from the list below
Please Select
Dr Adem Mercan
Dr Alix Lightfoot
Dr Amos Nichols
Dr Aoibheann Clarke
Dr Beck Whiting
Dr Carla Wormald
Dr Chad Elbaali
Dr Claire Mann
Dr Cooper Crimmins
Dr Dominic Siu
Dr Essie
Dr Haylee
Dr Kat Daley
Dr Kate Browne
Dr Kate Thompson
Dr Lauren Davis
Dr Lesley Hawson
Dr Megha Lim
Dr Mel Hayde
Dr Melissa Closter
Dr Monica Dickson
Dr Paddy Hannemann
Dr Pat
Dr Penelope Morrison
Dr Pippa Henderson
Dr Samantha Rulli
Dr Sarah Triglia
Dr Sasha Chatto
Dr Sebastian Willitts
Dr Sophie Lambton
Dr Taylah Locastro
Dr Tarley McPadden
Please Select
Please Select
Dr Adem Mercan
Dr Alix Lightfoot
Dr Amos Nichols
Dr Aoibheann Clarke
Dr Beck Whiting
Dr Carla Wormald
Dr Chad Elbaali
Dr Claire Mann
Dr Cooper Crimmins
Dr Dominic Siu
Dr Essie
Dr Haylee
Dr Kat Daley
Dr Kate Browne
Dr Kate Thompson
Dr Lauren Davis
Dr Lesley Hawson
Dr Megha Lim
Dr Mel Hayde
Dr Melissa Closter
Dr Monica Dickson
Dr Paddy Hannemann
Dr Pat
Dr Penelope Morrison
Dr Pippa Henderson
Dr Samantha Rulli
Dr Sarah Triglia
Dr Sasha Chatto
Dr Sebastian Willitts
Dr Sophie Lambton
Dr Taylah Locastro
Dr Tarley McPadden
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8
Please select the veterinarian that is coming to assist with your pet's farewell from the list below
Please Select
Dr Jared Du Mond
Dr Kym Tapley
Dr Marisa Wood
Dr Petra Cernikova
Dr Shelley Teakle
Dr Thomas Andrew
Please Select
Please Select
Dr Jared Du Mond
Dr Kym Tapley
Dr Marisa Wood
Dr Petra Cernikova
Dr Shelley Teakle
Dr Thomas Andrew
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9
Please indicate the pace at which you would like your pet's farewell to proceed
I would like everything to be over as quickly as possible with a minimum of fuss
I would like for things not to be rushed, but do not need extra time at any stage of the process
I would like things to proceed at a slow pace and may wish to pause at various points through the process to have time alone with my pet
I would like like as much time as possible at each stage of the process to have time alone with my pet
None of these options quite fit (your preferences can be detailed later in the questionnaire)
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10
How would you prefer we interact with your pet during our visit?
I would like you to be in contact with my pet as little as possible, so that their focus can be on me/us as a family
I am comfortable for the vet to interact with my pet as much as they like so long as it is not excessive
I would like the vet to make friends and interact with my pet as much as possible. It's very important to me that they bond
None of these options quite fit (your preferences can be detailed later in the questionnaire)
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11
How would you prefer we interact with you during our visit?
I would prefer that conversation be kept to only what is necessary for the procedure to allow me to focus as much as possible on being with my pet
I am happy to chat with the vet about my pet's life etc. in addition to conversation about the essential aspects of the process
I am happy to chat throughout the process as much as the vet likes and to keep things light
None of these options quite fit (your preferences can be detailed later in the questionnaire)
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12
If we are transferring your pet to our cremation partner for aftercare, is there a favourite blanket or similar you would like them to travel in?
No, if you can please provide something that would be appreciated
I have a blanket or similar that I would like my pet to be transported in
I am burying my pet at home or making my own aftercare arrangements
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13
If you have any other special requests or information you would like to share with our vet to make your pet's farewell as perfect as possible for you and for them, please share it below 🤗
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