Fear Free Questionnaire Please fill out our Fear Free form before your first visit. Name * First Name Last Name Pet's Name * Does your pet show any reluctance to getting in the carrier or car? * Yes No How would you describe your pet's behavior during travel? * Select all that apply Eager & excited Subdued/more quiet than usual More vocal than usual None Does your pet do any of the following during travel? * Select all that apply Pant Tremble Pace Hide Drool Vomit Poop Pee None Are there any situations that your pet has tried to avoid or seemed to dislike in the past? * Select all that apply Entering the vet hospital Unfamiliar people or animals Being weighed Going into the exam room Being put up on the exam table Having a rectal temperature taken Ear exam Cleaning Nail Trim None Has your pet ever been given any supplements or prescribed medications to help manage his/her fear or anxiety associated with vet visits? If so, what was it and what sort of results did you experience? * Has your pet ever bitten someone? * Yes No Is there anything else about your pet you would like us to know? Thank you!
