Fear Free Questionnaire
Client first and last name
How would you describe your pet's reaction to coming to the vet?
Eager and Excited
Some where in between
Check any situations listed below that your pet has shown avoidance or dislike of in the past. You can add additional comments at the end
Getting in their carrier or the car
Entering the Veterinary Hospital
Other pets and/or people and animals in the waiting area
Being approached by veterinary staff
Getting on the scale for a weight
Hearing the doorbell, overhead intercom, or phones ringing
Sounds coming from the back areas of the practice
Going into the exam room
Being put up on the table for examination
Having dirct eye contact with the technician and/or veterinarian
Loud voices during examination
Having a rectal temperature taken
The use of instruments such as the stethoscope or otoscope (to look in the ears)
Being taken out of the exam room for procedures
If your pet is a dog, are they on any heartworm prevention? If so what kind and are they on it year-round or seasonally?
What kind of food does your critter eat?
Is your pet due for any vaccinations?
Does your pet have any food allergies? If so please list them below:
Do you or your family members have any food allergies we should know about? We routinely use peanut butter, cheeses and other allergens in our hospital.
Do you have any current concerns about your pet's health?
How and where does your pet travel in the car? (carrier, seat belt, loose, ect)
How does your pet behave in the car?
Does your pet show any signs of nausea with car travel, such a drooling or vomiting?
How would you describe your pet around other animals and people?
Does your pet have any sensitive areas that he doesn't like to have touched or examined by you or others?
Are there any procedures your pet has not liked having performed at the veterinary hospital in the past or that seemed difficult for you or the staff to do? (nail trims, weight, temperature, ear exam, blood draw) if so, how did your pet react?
What are your pets favorite treats? ( please bring some to your next visit to our hospital, and please bring your pet hungry)
Does your pet like to play with toys? If so what kinds?
Has your pet ever been prescribed and medications to help with a visit to the veterinary hospital? if so, please list below
Anything else you would like us to know?
Send me a copy of my responses.
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This form was created inside of Critter Care Animal Hospital.