Fear Free Questionnaire – Town & Country Animal Hospital

Fear Free 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, I'd like to ask you a few questions so we can take both you and your pet's preferences for your first visit to our hospital into consideration.

Pet Name*
First
Owner Name*
First Last
How would you describe your pet's reaction to going to the veterinary hospital?
- Eager and excited
- Calm but reluctant
- Anxious
- Totally resistant
Are there any things that you or your pet did not like during past veterinary visits?
- Entering the veterinary hospital
- Getting on the scale for a weight
- Being put on the exam table
- Having a rectal temperature taken
- Waiting with other people and animals in the waiting area
- Going into the exam room
- Being handled by veterinary staff
- Being taken out of the exam room for procedures
- Other
Does your pet prefer:
- Female Veterinary Professional
- Male Veterinary Professional
- It doesn't matter
What are your pet's favorite treats or does your pet have a favorite toy
We suggest you bring your pets favorite treats or toy and bring them hungry
Does your pet show any reluctance to getting in the carrier or car?
- Yes
- No
How and where does your pet travel in the car?
- Carrier
- Seatbelt
- Loose
How does your pet behave in the car?
- Happy
- Vocal
- Barking
- Whinning
- Restless
- Pacing
- Panting
- Trembling
- Hiding
Any nausea, drooling or vomiting, with car travel?
- Yes
- No
Anything else you would like us to know?

Monday	8:00am – 6:00pm
Tuesday	8:00am – 6:00pm
Wednesday	8:00am – 6:00pm
Thursday	8:00am – 6:00pm
Friday	8:00am – 6:00pm
Saturday	8:00am – 12:00pm
Sunday	Closed

Fear Free Pre-Visit Questionnaire

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