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* 1. Client's Name

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* 2. Pet's Name

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* 3. Does your pet show any reluctance to getting in the carrier?

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* 4. During travel to the veterinary hospital, does your pet show any of the following behaviors?

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* 5. Does your pet prefer:

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* 6. 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.

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* 7. How would you describe your pet around other animals and people?

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* 8. Does your pet have any sensitive areas that s/he does not like to have touched 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 (e.g., nail trims, weight, temperature, ear exam, blood draw)? If so, how did your pet react?

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* 9. What are your pet's favorite treats? (Please bring some to your next visit to our hospital.)
Does your pet like to play with toys? If so, what kinds?

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* 10. 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?

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