Skip to main content
Hit enter to search or ESC to close
Home
About
Fear Free
Our Veterinarians
Our Care Team
Careers At EWAH
Employment Form
Services
Acupunture & TCVM
Behavior Services
Dental Care
Laboratory & Diagnostics
Microchipping
Personalized Vaccine Care
Stance Analysis
Summus Laser Therapy
Surgery Services
Ultrasound, Echo & Endoscopy
Wellness & Prevention Plans
Client & Patient Center
Client Center
Annual Client Form & Hospital Policies
Procedure Anesthesia & Medical Authorization Release
Pet & Pet Parent Social Media Agreement
Payment Options
Patient Center
Pet Information
Pre-Visit Questionnaire
Behavior Questionnaires
Pet Health
Pet Health Library
How-To Videos
Pet Health Checker
Pet Food Recalls
Product Recalls
Pet Insurance
News
East-West Blog
Promotions
Contact
Online Store
facebook
instagram
search
Pre-Visit Questionnaire
Pre-Visit Questionnaire
As Fear Free Certified Professionals, we want to make your pet’s veterinary experience as enjoyable and as stress-free as possible. As such, it is important for us to understand what your pet might find upsetting. The information you provide will help us to adjust our care to better serve and comfort your pet. Please answer the following questions to the best of your ability so we can take into consideration both your and your pet’s preferences.
Your Name
*
First
Last
Your Pet's Name
*
Does your pet show any reluctance to get in the car or carrier?
*
Yes
No
How would you describe your pet’s behavior during travel?
*
Eager & excited
Subdued
More quiet than usual
More vocal than usual
Does your pet do any of the following during travel:
Pant
Tremble
Pace
Hide
Drool
Vomit
Poop
Pee
Are there any situations that your pet has tried to avoid or seemed to dislike of in the past – check all that apply:
Entering the veterinary hospital
Going into the exam room
Being removed from the carrier
Unfamiliar people and / or animals
Being put up on an exam table
Having a rectal temperature taken
Getting on the scale
Being picked up or carried
Ear exam / cleaning
Nail trim
Placement of stethoscope on their chest
Any other situtations?
Has your pet ever been given any supplements or prescribed any medications to help manage his / her fear or anxiety associated with the visit?
*
No
Yes
? If so, what was it and what sort of results did you experience?
Δ
Home
About
Fear Free
Our Veterinarians
Our Care Team
Careers At EWAH
Employment Form
Services
Acupunture & TCVM
Behavior Services
Dental Care
Laboratory & Diagnostics
Microchipping
Personalized Vaccine Care
Stance Analysis
Summus Laser Therapy
Surgery Services
Ultrasound, Echo & Endoscopy
Wellness & Prevention Plans
Client & Patient Center
Client Center
Annual Client Form & Hospital Policies
Procedure Anesthesia & Medical Authorization Release
Pet & Pet Parent Social Media Agreement
Payment Options
Patient Center
Pet Information
Pre-Visit Questionnaire
Behavior Questionnaires
Pet Health
Pet Health Library
How-To Videos
Pet Health Checker
Pet Food Recalls
Product Recalls
Pet Insurance
News
East-West Blog
Promotions
Contact
Online Store
facebook
instagram