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's important for us to understand what your pet might find upsetting. The
information 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 you and your pet's preferences. You can
reach us at 760-444-0342. Thank you
Owner First Name:
Owner Last Name:
Phone number where you can be reached:
Type of Pet (dog/cat/bird/reptile etc):
Pet Insurance(if Applicable):
Does your pet show any reluctance to getting in the carrier or car?
How and where does your pet travel in the car? (carrier, seatbelt, loose etc.)
During travel to the veterinary hospital, does your pet do any of the following? If you have a BIRD, skip and
Eager & Excited
Other (explain below)
If you checked "Other" above, explain.
If your pet is a BIRD, during travel to the veterinary hospital, does your bird do any of the
Eyes wide open
Feathers slicked tight
Freezing in place
Trying to fly away/escape
Does your pet prefer:
Female veterinary professional
Male veterinary professional
It doesn't matter
Getting in their carrier or the car
Entering the veterinary hospital
Other pets and/or people passing by while in reception/check-in
Being approached by veterinary staff
Getting on the scale for a weight
Hearing the doorbell, overheard intercom, or phone ringing
Sounds coming from the back areas of the practice
Going into the exam room
Being put up on the table for examination
Having direct 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 ear)
Being taken out of the exam room for procedures
Any additional comments can be made below:
How would you describe your pet around other animals and people?
Does your pet have any sensitive areas that they do not like to have touched by you or
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 trim, weight, temperature, ear exam, blood draw etc.) If
so, how did your pet react?
What are your pet's favorite treats? (Please bring some to your next visit to our
Does your pet like to play with toys? If so, what kind?
Has your pet ever been prescribed any supplements or medications to help with a visit to the veterinary
hospital? If so, what was it and what sort of results did you experience?
Anything else you would like us to know?
Please include the name and contact number for your current veterinarian.