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Menu
About
Vets & Management
Our Team
Career Opportunities
Services
Acupuncture
Dentistry
Herbal Medicine
Nutrition
Physical Therapy & Rehabilitation
Laser Therapy & Shockwave Therapy
Surgical Services
Traditional Chinese Medicine
Vaccination
Wellness
Resources
Online Pharmacy
Patient Forms
Pet Insurance
Contact Us
Patient Personality Questionnaire
Pet Name
Your Name
First
Last
Does your pet show fear, stress or anxiety when visiting the veterinary clinic?
Yes
No
Has your pet ever been prescribed supplements/medication for veterinary visits? If so, what kind and did it help?
Please select any of the following that cause your pet fear, anxiety, or stress:
Getting in the car/carrier
Loud noises
Waiting around other pets in the lobby
Being approached by veterinary staff
Eye contact with veterinary staff
Physical contact from veterinary staff
Getting on the scale
Entering the exam room
Being lifted to the exam table
Loud voices during examination
Having rectal temp taken
Use of instruments during examination
Being taken out of exam room for procedures
Sounds like phones ringing, doorbells, etc.
How is your pet around other animals?
Eager/excited
Reluctant
Fearful
Aggressive
How is your pet around other people?
Eager/excited
Reluctant
Fearful
Aggressive
Areas your pet is sensitive to during examination:
Ears
Eyes
Mouth
Nose
Neck
Chest
Stomach
Back
Front Legs
Back Legs
Paws
Tail
Rump
Rectum
Genitals
None
Procedures that are stressful for your pet (nail trims, anal glad expression, temperature, etc.)
Does your pet have favorite treats? If so, what kind?
Does your pet have favorite toys?
Is there anything else you’d like us to know?
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