Fear Free Form Fear Free Questionnaire Fear Free Questionnaire 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. Name * Name First First Last Last Email * Date * Pet's Name * 1) How you would you describe your pet's reaction to going to the veterinary hospital? * Eager and Excited Subdued Reluctant Somewhere in between 2) 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 carrier or car Entering vet hospital Being approached by vet staff Getting on scale for weight Going into exam room Loud voices during examination Being put up on table for examination Having a rectal temperature taken Being taken out of exam room for procedures Direct eye contact with tech and/or vet The use of instruments such as the stethoscope or otoscope (to look in the ears) Hearing the doorbell, intercom, or phones ringing sounds from the back areas of the practice Pets or people passing by while in reception waiting with other people and animals in the waiting area 3) How and where does your pet travel in the car? * Carrier Seatbelt Loose OtherOther 4) Does your pet show any signs of nausea with car travel, such as drooling or vomiting? * Yes No 5) How does your pet behave in the car? * 6) How would you describe your pet around other animals and people? * 7) Does your pet have any sensitive areas that he does not like to have touched or examined by you or others? * 8) Are there any procedures your pet has not liked having performed at the vets? If so, how did your pet react? * 9) What are your pet's favorite treats? (Please bring some to your next visit to our hospital) * 10) Does your pet like to play with toys? If so what kinds? * 11) Has your pet ever been prescribed any medications to help with a visit to the veterinary hospital? If so, please list below: 12) Anything else you would like us to know? Captcha Submit If you are human, leave this field blank.
