New Patient Pre-visit Questionnaire

Thank you for choosing Veterinary Medical Center of Fort Mill for your pet care needs.

As a Fear Free Certified Practice, we want your pet’s experience at our hospital to be as positive and stress-free as possible right from the start. Therefore, it’s important for us to understand what, if anything, your pet might find upsetting. Any information you can provide will help us to customize our treatments to try to help your pet stay calm and relaxed throughout the visit. Please answer the following questions to the best of your ability and let us know if you have any questions.

Client Name(Required)

First

Last

Email(Required)

Pet's Name(Required)

Does your pet show any reluctance to getting in the carrier or car?(Required)

Yes

How would you describe your pet's behavior during travel? (select all that apply):(Required)

Eager & excited

Subdued

More quiet than usual

More vocal than usual

Does your pet do any of the following during travel? (select all that apply):(Required)

Pant

Tremble

Pace

Hide

Drool

Vomit

Poop

Pee

None of the above

Are there any situations that your pet has tried to avoid or shown dislike of in the past? (select all that apply):(Required)

Entering the vet hospital

Unfamiliar people or animals

Being weighed

Going into the exam room

Being put up on the exam table

Have a rectal temperature taken

Nail trim

Other

Please explain.(Required)

If "other", please describe(Required)

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

Does your pet have any sensitive areas that s/he does not like to have touched by you or others?(Required)

What are your pet’s favorite types of treats? Please bring some with you for their upcoming visit.(Required)

Are any treats that your pet CAN'T have or any food allergies in the family that we should be aware of?(Required)

Has your pet ever been given any supplements or prescribed any medications to help manage his/her fear or anxiety associated with the visit?(Required)

Yes

If so, which medication was it and what sort of results did you experience?(Required)

We will take the time to let your pet set the pace for treatment and take breaks as needed. But if we have tried a couple of times and it’s just too stressful for them, then our doctors will recommend medications to help decrease their stress and anxiety, and we'll make a plan to try again another day.(Required)

I think these medications might help my pet.

I’m interested in more information or have questions about this.

I understand.

Anything else you would like us to know?