Information Gathering for Holistic wellness Consultation.

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Please fill the form with as many details as possible. If you need to gather the details over the next day, please do so before filling it in.

Your Name *

Email *

Mobile number *

Postal Address (with pin code) *

Dog's name *

Please fill one form for one dog only.

Breed *

Age *

If your puppy is under the age of 1 year, please use 0.x to state the number of months your pup is.

Weight (In Kilos) *

Is your dog overweight? *

Yes

Maybe

I dont know

Spayed or neutered *

Yes

What are the primary concerns you wish to address during this consultation? *

How many people in the household? Please list profession and work schedules for adults and age for all the kids. *

How many hours is the dog typically alone at home? *

Detailed information.

The following are detailed questions about your dog's health and nutrition.

Are you willing to feed the dog a species appropriate meat based diet? *

yes

Current diet *

Please add timings, measured quantity for each meal of the day. Do not include snacks

Snacks during any typical day *

Please include exact snacks and quantity with timings.

Medical History from the past *

Please state any major or minor medical issues that have happened in the past, which may or may not be existing currently.

Any Current Medical Conditions? *

Cardiac Conditions

Joint conditions

Liver conditions

Kidney Conditions

Excess Weight

Under weight

Cancer

Digestive Conditions

Tumors

Pancreatic Conditions

Skin Conditions

None of the above

Other:

Required

Please give details about the above mentioned conditions *

Please provide adequate details about the conditions and medications and current status.

Are there any known Allergens for your dog? *

Are they any ingredients or food items you know your dog does not like? *

What time does the dog usually wake up? *

Time

What time does the dog usually go to bed for the night? *

Time

Where does the dog typically sleep? *

How many walks does the dog have daily?

None

Clear selection

How long do these walks last? And where do these walks take place? *

Please give timings for various walks if different. Also location of walks for eg. in the building compound, on the main road, in a park etc.

How long do you think your dog sleeps during a 24 hour period? *

Select the most accurate option rather than a generalized option

Less than 5 hours

Less than 8 hours

Less then 10 hours

Less than 12 hours

Less then 14 hours

Less then 16 hours.

Do you think your dog is *

You may choose Multiple options

Well rested

Calm

Sober

Mildly Hyper

Moderately hype

Very hyper

Uncontrolable

Required

Please explain your answer above. *

Has your dog ever bitten a human? *

Yes

Has your dog ever bitten another dog? *

Yes

How do you define a "Bite" differently from Nipping? *

Does your dog have behavioral problems that you want to address? *

Please describe in detail.

Submit

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