Canine Nutritional Coaching Questionnaire Owner's Name(Required) First Last Mobile Phone(Required)Pet's Name(Required) A certified veterinary technician who focuses on wholesome, healthy, science-based dog nutrition will be creating a plan for your friend! Which of these communication methods do you prefer for them to discuss the plan with you?(Required) Virtual Coaching (Zoom) Phone Call Email Please list any/all emails you would like used(Required) When completing this form, please know that details matter. The more information you tell us about what your dog is eating, the more accurately your coach will be able to assess your dog's current nutrition so that they can create a plan to reach your shared goals!In detail, please list all dry food kibble that is given.(Required)Please include brand, flavor, and formula. If you are unsure what to include, feel free to include a screenshot of the food to show us. Also helpful is the calories per cup or can (this should be listed as "kcal" somewhere in the ingredients area of the bag.If you would like, you can upload photos of the food bag or screenshot here. Drop files here or Select files Max. file size: 50 MB. In detail, please list all canned, pouch, or moist food that is given.(Required)Please include brand, flavor, and formula. If you are unsure what to include, feel free to include a screenshot of the food to show us. Also helpful is the calories per cup or can (this should be listed as "kcal" somewhere in the ingredients area of the bag.If you would like, you can upload photos of the food can or screenshot here. Drop files here or Select files Max. file size: 50 MB. Do you currently measure your dog's meals?(Required) Yes No What do you use to measure the food? (i.e. 8oz baking cup, ½ cup scoop, coffee cup, scale, Sheetz big gulp)(Required) How much do you feed your dog at each meal and how many meals are they given daily?(Required) Please provide a photo of your measuring scoop or scale.(Required)Max. file size: 50 MB.Please describe the container you put food in and how often your pet empties it. If you can compare the container to something to help us know size or even measure how many 8 oz cups of cereal or food it holds that would be very helpful.(Required)In detail, please list all dog treats fed, including the amount your dog gets each day for each of them.(Required)Be as specific as possible with the brand, flavor, and size (S, M, L) of the treat. If the calories per treat are listed on the label, please include that info.If you would like, you can upload photos of the treats bag/box/pouch or screenshot here. Drop files here or Select files Max. file size: 50 MB. In detail, please list all people food given (this includes things like chicken, cereal, or table scraps).(Required)Please try to estimate how often this occurs, what type of food is given, and how much.The following information helps us guide your home plan:Who feeds your dog meals?(Required) Who feeds your dog treats?(Required) Who feeds your dog food?(Required) Does your dog have access to any other pet's food (cats, other dog, etc.)?(Required) Yes No Please tell us what food they have access to and approximately how much of it they eat on a regular basis.(Required) Do you currently use any food puzzles, slow feeders or kong toys?(Required) Yes No What and how much do you fill them with?(Required) Does your dog get a treat after potty breaks?(Required) Yes No What treat and how many times per day?(Required) What products are you currently using for dental care?(Required)If you would like, you can upload photos of the dental products or screenshot here. Drop files here or Select files Max. file size: 50 MB. Please explain your dog's activities and exercise - tell us what they do, how many times they do it and for approximately how long. (examples: free run of the back yard, leash walks, hiking, swimming, frisbee, fetch, couch potato)(Required)Please include daily, weekly, and monthly activitiesPlease mark all concerns you have about your dog's new nutrition plan(Required) Taste Safety Effectiveness Upset Stomach Cost Other None Foods and treats purchased through Healing Paws Veterinary Care are all money back guaranteed. If they don't like the taste, we will make it right! What flavors does your dog like the most?(Required) Tell us what safety concerns you have.(Required)We will guide you on how to make a gradual transition and may even include probiotics to make that easier. Can you tell us about what, if any, stomach upset your dog has had with food in the past?(Required)We also consider safety, effectiveness, and cost in all of our recommendations. What is your monthly budget allowance for your dog's food? (We will do our best to create a plan that is within your budget.)(Required)Thank you so much for your time. You will hear from Amanda, our certified veterinary technician, soon with a plan to help your dog live its best life!CAPTCHANameThis field is for validation purposes and should be left unchanged.
