Fear Free Pre-Visit Questionnaire

Pre-Visit Questionnaire

As a Fear Free Certified Professional team, we want to make your pet’s veterinary experience as enjoyable and stress-free as possible. It is important for us to understand what your pet might find enjoyable or upsetting before, during, and after the appointment. Please answer the following questions to the best of your ability so we can take into consideration both you and your pet’s preferences.

Your Name

Your Pet’s Name

How does your pet behave during travel in the car? (Check all that apply)
Happy/Enjoys the RidePaces/PantingLays Down/ComfortableOther

If Other, please describe:

Does your pet show any signs of nausea with car travel?
YesNo

If Yes, please describe the signs of nausea:

How do you describe your pet’s reaction to entering the veterinary hospital?
Happy/Enjoys the EnvironmentPaces/PantingDoes not like to interact with other dogsDoes not like to interact with people

What are your pet’s favorite treats? (Check all that apply)
CheesePeanut ButterStore-Bought TreatsOther

If Store-Bought or Other, please describe your pet’s preferred treats:

Does your pet enjoy getting on the scale for weight measurement?
YesNo

Does your pet have any sensitive areas where he/she does not like to be touched or examined by you or others? (Check all that apply)
EarsFace/Teeth/EyesFeetTail/Rear EndOther

If Other, please describe:

How does your pet react to exiting the hospital?
Happy/Enjoys LeavingReluctant to LeaveNo Preference

How does your pet behave upon re-entering the home and/or upon re-introduction to home with other pets? (Check all that apply)
Happy/Smooth ReturnHidesOther pet(s) will not leave him/her aloneOther

If Other, please describe:

Please share any additional information you would like us to know: