Fear Free Pre-Visit Client Questionnaire Client's Full Name* First Last Email* Pet's Name* Pet's Specie* Canine Feline Other As a Fear Free Certified Professional team, 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 your & your pet’s preferences. How would you describe your pet’s reaction to going to the veterinary hospital? Eager and Excited Subdued/Restrained Reluctant Somewhere in between Before the appointment, the patient prefers to wait in the: Car Lobby Exam Room Outside Other Patient's favorite treats are: Is anyone in the household allergic to peanut butter?* Yes No Not Sure Does the patient likes to play with toys? If yes, what kind? Things the patient enjoys that helps as distraction during a medical procedure: Patient prefers to be examined: On the ground On the table On a non-slip mat or towel In lap In the carrier Other How and where does the patient travel in the car? How does the patient behave in the car? Does your pet show any signs of nausea with car travel, such as drooling or vomiting? Yes No How would you describe your pet around other animals and people?Does the patient have any sensitive areas that he/she does not like to have touched or examined by you or other?Any of these procedures the patient has not liked having performed at the veterinary hospital in the past or that seemed difficult for your or the staff to do? Nail Trims Weight Temperature Ear Exam Blood Draw Other Has the patient ever been prescribed any medications to help with a visit to a veterinary hospital? If so, which one? Anything else you would like us to know to make the experience a better one?