Canine Lab Intake Form - ParsleyPet
Remember, be as specific as possible in your answers. This will help us provide a more accurate recommendations when your results are reviewed.
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PLEASE READ
HTMA analysis identifies mineral and heavy metal uptake in your pet for a period of 30-45 days from the time the hair sample is taken. Cutting the hair and not sending in the sample immediately does not make the test obsolete. However, it does decrease accuracy in regard to your dog's current health. For this reason, we suggest that send in samples immediately after getting the sample and re-testing every 6-12 months. When you establish trends over time you gain significantly more information about your pet's overall health. 
Lab/Diagnostics
If you have any test results of any kind, please send them to us at 

Hello@parsleypet.com

The more information, the better when preparing your analysis. 

DISCLAIMER:
Limitations of use - ParsleyPet agrees to honor your purchase for a term of 3 months from the date of purchase. 

Refunds - If you are unable to send in a hair sample within 3 months of purchase we will refund your test, minus a 15% fee for administrative efforts already completed for intake. 

Once your hair sample has arrived at the lab, we are unable to refund your order. 

We understand that life happens and sometimes there are unique circumstances that fall outside of expected parameters.  If you feel you need to speak to us regarding our terms and conditions please reach out to us at hello@parsleypet.com 

We do not know if ParsleyPet tests are covered by your pet's insurance provider. ParsleyPet provides laboratory-tested mineral and heavy metal uptake results. The analysis is provided by individuals certified in HTMA analysis. ParsleyPet does not offer veterinary care or services in any form.  If you choose to receive a consult through our ParsleyPet experts, we may provide a list of non-medical foods or supplements to serve your needs.
Pet Owners Information
Name *
First and Last name, for tracking purposes, please
What is your age range?
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Pet's Name *
City you live in
This may assist us in identifying environmental contaminants common in your area
State you live in *
This may assist us in identifying environmental contaminants common in your area
Pet's Information
Please be as detailed as possible
Breed *
If your dog is a mixed breed, please describe all possible breeds
Pet's Age *
Estimated age is acceptable
Pet's sex *
Pet's Weight *
This may help us identify common associations between weight related issues and mineral/heavy metal imbalances
Is your pet at the right weight?
Clear selection
If your pets weight is not "just right", please state how many pounds they need to gain or lose.
Activity Level
This may help us identify associations between energy levels and mineral/heavy metal imbalances
Low
High
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Please describe your pets daily activity and duration
Neutered or Spayed *
This may help us identify associations between mineral imbalances and hormones
Age of your pet at time of spay/neuter
If you don't know you put say, "I don't know" or say "Possibly (your answer here)"
Your pet's food, supplements and medication
Please provide as much detail as possible
Type of Food you feed your pet *
This may help us identify common imbalances associated with specific categories of diets
Required
Brand/s of Food used *
Please list all brands used in the last 90 days. If your pet is fed a homemade diet, please state brands of products you use then continue with details below
Flavor of food (what protein or blend do you use)
Please list the proteins (e.g. Chicken) or blends (e.g. Fish & Sweet Potato) that you use
How much food do you feed per day? *
Please provide food amount in ounces, cups or grams
If you feed homemade, what quantity of MUSCLE MEAT do you feed every day?
IF YOU FEED HOMEMADE, THIS ANSWER IS REQUIRED. Please provide food amount in ounces, cups or grams
If you feed homemade, what quantity of ORGAN MEAT do you feed every day?
IF YOU FEED HOMEMADE, THIS ANSWER IS REQUIRED. Please provide food amount in ounces, cups or grams
If your provide additional bones or bone-in meats, please describe them.
IF YOU FEED HOMEMADE, THIS ANSWER IS REQUIRED. Please provide details such as "2 raw marrow bones per week, 4" each" or "1 duck head per day", etc
If you feed homemade, what quantity of FRUITS & VEGGIES do you feed every day?
Treats *
Please provide brands, flavors and quantities
Toppers *
Please provide brands, flavors and quantities
Supplements and Dosages *
Please provide brands and frequency. If you feed homemade and answered this above you may write, "see above"
Do you give a Vitamin D supplement and/or have you done serum Vitamin D testing?
"Serum Vitamin D" testing is a blood test.  It is NOT done with a basic blood panel - you would have had to specifically request it
Clear selection
If you have more information about your pets Vitamin D levels, please describe them here
Vitamin D helps to regulate minerals. This information may help us identify associations between your pets Vitamin D levels and their ParsleyPet results
Medications *
Please include name, prescribed dosage and frequency of usage. This information may help us identify associations between mineral/heavy metal uptake levels and certain medications
How often does your dog receive a bath? What products are used? *
This information will help us understand the quality of your pets hair sample
When was the most recent bath? *
MM
/
DD
/
YYYY
When was your pets last dental?
This information may help us identify associations between dental health/disease and mineral/heavy metal balance/retention
MM
/
DD
/
YYYY
Please describe your pets dental health
Do you use Flea and Tick preventative medicines? *
If you use Flea & Tick medication, what brand and how often?
This information may help us identify associations between specific medications and mineral imbalances and heavy metal retention
Do you use Heartworm medication?
Clear selection
If you use Heartworm medication, what brand and how often?
This information may help us identify associations between specific medications and mineral imbalances and heavy metal retention
Please describe your pets primary medical issue(s) *
This information may help us identify associations between specific mineral imbalances or heavy metal toxicities and health problems.
Please CHECK any conditions the apply: *
Required
Other relevant medical issues or notes
Date your ParsleyPet Hair Sample was collected *
MM
/
DD
/
YYYY
How did you hear about us? *
Would you like us to email you more detailed information on consultation services we offer?
We would send you a single email that summarizes our services. Through this email you may choose to opt into additional communication. Selecting yes here does not opt you into multiple communications.
Clear selection
I understand that I must send in my hair sample no later than 90 days after purchase. No refunds will be issued for tests purchased without a sample received within 90 days.  *
Required
Questions and comments
Terms & Conditions
HTMA analysis identifies mineral and heavy metal uptake in your pet for a period of 30-45 days from the time the hair sample is taken. Cutting the hair and not sending in the sample immediately does not make the test obsolete. However, it does decrease accuracy in regards to your dogs current health. For this reason we suggest that send in samples immediately after getting the sample and re-testing every 6-12 months. When you establish trends over time you gain significantly more information about your pets overall health.

Limitations of use - ParsleyPet agrees to honor your purchase for a term of 3 months from the date of purchase.

Refunds - If you are unable to send in a hair sample within 3 months of purchase we will refund your test, minus a 15% fee for administrative efforts already completed for intake.

Signatures and Insurance - ParsleyPet does not offer signatures for insurance credits or other reasons. If you would like insurance reimbursement or other medical support in relation to your ParsleyPet test results, we suggest collaborating with a veterinarian directly. ParsleyPet testing does not constitute a client/veterinary relationship and is not considered medical treatment, diagnoses, care or otherwise.

We understand that life happens and sometimes there are unique circumstances that fall outside of expected parameters.  If you feel you need to speak to us regarding our terms and conditions please reach out to us at hello@parsleypet.com 
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