Fear Free Questionnaire

Client Name*:

Pet's Name*:

As Fear Free Certified Professionals, 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 and your pet’s preferences

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

During travel to the veterinary hospital does your pet do any of the following?

 Eager & Excited    Reluctant    Hide    Drool   Vomit    Urine/BM    Subdued   Bark/Meow    Whine    Pant   

 Tremble    Pace   Other  

Check any situations listed below that your pet has shown avoidance or dislike of in the past.

  Getting in their carrier or the car  Other pets and/or people passing by while in reception
  Entering the veterinary hospital   Being put up on the table for examination
  Going into the exam room   Having direct eye contact with the technician and/or veterinarian
  Loud voices during examination  Waiting with other people and animals in the waiting area
  Being approached by veterinary staff   Having a rectal temperature taken 
  Getting on the scale for a weight   The use of instruments such as the stethoscope or otoscope (to look in the ears)
  Being taken out of the exam room for procedures   Hearing the doorbell, overhead intercom, or phones ringing
  Sounds coming from the back areas of the practice 

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

 

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? (nail trims, weight, temperature, ear exam, blood draw) 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 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? 

 

Anything else you would like us to know?

 


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Our Funkstown veterinarians offer a wide variety of pet care services including spay and neutering, general exams, vaccinations, and much more. Contact Animal Health Clinic of Funkstown today to schedule an appointment at our Funkstown, Maryland veterinary office.

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