Fear Free FAS Pre-visit Questionnaire:

As Fear Free certified professionals, we want to make your visit to our hospital the best it can be for you and your pet. If you have a few minutes, we would like for you to answer a few questions so we can take both you and your pets preferences for your first visit to our hospital. This short questionnaire will help us get to know your pet… A Fear Free visit starts at home!

Client Name*

First Last

Pet Name*

1. Does your pet show any reluctance to get in the carrier or car?*

2. How and where does your pet travel while in the car?*

3. During travel to the veterinary hospital, does your dog do any of the following? (check all that apply)*

4. Does your pet prefer:*

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

6. Briefly describe your pet around other animals and people, such as in the lobby area of a veterinary hospital?*

7. Does your pet have any sensitive areas that he/she does not like touched or examined by you or others? (i.e. paws, ears, tail, etc)*

8. What are your pet’s favorite treats? (We recommend you bring some to the visit!)*

9. Does your pet like to play with toys? If so, what kind? (We recommend you bring their favorite to the visit!)*

10. Has your pet ever been prescribed any medications to help with a visit to a veterinary hospital? If so, what medications were they and what results did you experience?*

11. Is your pet on these medications today?*