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Home » Fear Free Pre-Visit Client Questionnaire

Fear Free Pre-Visit Client Questionnaire

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Owner's Name*

First

Last

Pet's Name*

Date

MM slash DD slash YYYY

How would you describe your pet’s reaction to going to the veterinary hospital?

Eager and Excited

Subdued

Reluctant

Somewhere in between

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 their carrier or the car

Entering the veterinary hospital

Other pets and/or people passing by while in reception/check-in

Waiting with other people and animals in the waiting area

Being approached by veterinary staff

Getting on the scale for a weight

Hearing the doorbell, overhead intercom, or phones 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 ears)

Being taken out of the exam room for procedures

How and where does your pet travel in the car? (carrier, seatbelt, loose, etc.)

How does your pet behave in the car?

Does your pet show any signs of nausea with car travel, such as drooling or vomiting?

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

Does your pet have any sensitive areas that he does not like to have touched or examined 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? (Nail trims, 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 hospital.)

Does your pet like to play with toys? If so, what kinds?

Has your pet ever been prescribed any medications to help with a visit to the veterinary hospital? If so, please list these below:

Anything else you would like us to know?

Get in touch

919-825-1000

1005 Lichtin Blvd
Morrisville NC, 27560

Make an appointment

Make Appoinment

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Business Hours

Monday

7:30am - 6:30pm

Tuesday

7:30am - 6:30pm

Wednesday

7:30am - 6:30pm

Thursday

7:30am - 6:30pm

Friday

7:30am - 6:30pm

Saturday

8:00am - 12:00pm

Sunday

Closed

We are routinely closed on most major holidays. Click here to learn more.

919-825-1000

1005 Lichtin Blvd
Morrisville NC, 27560

Make an Appointment

Online Pharmacy

Home
About
Our Services
Online Pharmacy
Pet Parents
Education
Contact Us