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Consultation Appointment Questions
We have a few questions for you to help us tailor your Comprehensive Nutrition Plan to fit your pet's individual needs.
* Indicates required question
Email
*
Record my email address with my response
Your Name
Your answer
Your Phone Number
Your answer
How do you prefer to be contacted?
Phone
Email
Clear selection
Pet's Name
Your answer
Pet's breed (If your pet is a cat and you don't know the breed just say indoor/outdoor cat)
Your answer
Current weight
Your answer
Pet's age
Your answer
Is your pet spayed/neutered?
Yes
No
Clear selection
Activity Level
Lethargic Not Active
1
2
3
4
5
Hyperactive
Clear selection
What are you currently feeding your pet? (Please be as specific to Brand and Flavor.)
Your answer
How much do you feed your pet? (How many cups of dry food or ounces of wet food)
Your answer
What type of treats do you feed your pet? (Anything outside of meal time.)
Your answer
Do you currently give your pet human food, and if yes what do you feed?
Your answer
Do you currently use any supplements with your pet? (Fish oil, Joint health, calming treats, etc.)
Your answer
Does your pet have access to other food? (Sitter/daycare feeding something else or trash can)
Your answer
How many different people are responsible for feeding the pet at home?
Your answer
What is the consistency of your pet's bowel movements on a regular basis?
Soft Stool
1
2
3
4
5
Hard Stool
Clear selection
How would you Describe your pet's current weight?
Option 1 Very Thin
Option 2 Underweight
Option 3 Ideal Weight
Option 4 Overweight
Option 5 Obese
Clear selection
Does your pet have any known allergies? (Chicken, Wheat, Beef, etc.)
Your answer
Nutrition Concerns
Has your pet been diagnosed with any of the following medical issues by a Veterinary Doctor? (Please select all that apply)
Pancreatis
Cancer
Diabetis
Kidney Disease
Overweight
Underweight
Urinary Infections or Crystals
Diarrhea
Constipation
Dilated Cardiomyopathy (DCM)
Other
If you selected "Other", please specify your pet's condition
Your answer
What is your biggest concern regarding your pet's diet?
Your answer
Does your pet exhibit any of these behaviors?
Coprophagia (Stool eating)
Excessive Itching or Chewing on Self
Butt Scooting
Excessively drinking water
Sudden Lack of Energy
Vomiting
Sudden Weight Loss
Sudden Weight Gain
Anxiety
Is your pet currently on any medications? If yes, please list them below.
Your answer
Do you have a preference on whether your pet eats grain or grain free food?
Grain Inclusive
Grain Free
No Preference
Clear selection
Budget for daily feeding?
Kibble $
1
2
3
4
5
Raw or Fresh Diet $$$
Clear selection
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