Your Name
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First Name
Last Name
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
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Cell Phone
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(###)
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Who may we thank for referring you?
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Do you have any limitations we should know about in order to better assist you?
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Household products are amongst the top ten most common causes of acute toxicosis, chronic illnesses and cancer in pets. Are all of the chemicals and products used in your home non-toxic, "green", safe for pets and the environment? Do you use any harsh chemicals in or around your home, including air fresheners?
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Do you diffuse essential oils in your home? If so, which brand?
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What type of bowl does your dog eat and drink from?
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Please check all that apply.
What are the concerns that brought you here?
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Age
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Sex
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Is your dog altered?
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The removal of sex hormones plays a role in everything from behavior, mental well-being, physical structure, health span and life span; please consider scheduling a chat with Jen before you make a final decision.
Please tell us about any and all issues (training, behavior or otherwise) you are experiencing.
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The gut drives behavior; quite often many training and behavior issues can be nutrition related. Any details you can offer will be helpful to Jen.
Please list any expectations or goals for your dog in order of importance.
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This can cover anything from nutrition to training and behavior, travel, competition, etc.
Is your dog crate trained? If yes, what type of crate and how many hours per day?
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How does your dog react when you leave the house?
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Is your dog allowed to roam free in your house and yard?
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Please describe your walks together.
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Do you frequent places like dog parks, dog beaches and dog daycares?
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Does your dog have any fears or phobias?
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Is your dog possessive over food or toys? Growled or snapped at a person or other animal? Has your dog ever bitten anyone or attacked another dog or animal?
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Please list the name of your Veterinarian / Vet Hospital.
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Please list all types & brands of food your dog has been on since birth..
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Please list all medications your dog has been on since birth.
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Please list all supplements your dog has been on since birth.
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Please describe your feeding routine.
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Please include as many details as possible.
Please list all medical issues, injuries, allergies or sensitivities your dog has experienced since birth.
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Please list the type & brand of treats you use, including how many per day and when.
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Please indicate which vaccinations your dog has received since birth.
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Please check all that apply.
Please indicate which products your dog is on.
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Please check all that apply.
Consulting Options:
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WHAT QUESTIONS DO YOU HAVE FOR JEN?
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Our first communication will be via EMAIL - please be sure to check your SPAM / JUNK folder if you don't see a reply from Jen in 72 hours, it may be hiding! Please reply to that email to ensure smooth communication.
Please list any questions you have for Jen, this enables us to help you more efficiently.
To request a call, please offer three dates / times that you are available.
