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Visit Report Card
Name:
*
First
Last
Date:
*
Date Format: MM slash DD slash YYYY
My FAS Score During the Visit:
*
0 - He/She displayed no signs of FAS with a relaxed body language and solicited social interactions with team members.
1 - He/She displayed 1 or 2 subtle signs of FAS occurring less than 4 times a minute.
2 - He/She displayed 1 to 2 moderate signs of FAS occurring 4 or less times a minute.
3 - He/She displayed more than 2 moderate signs of FAS occurring more than 4 times in a minute.
4 - He/She displayed significant signs of FAS without aggression, such as immobility, fidgeting, escape behavior, dilated pupils, trembling, etc.
5 - He/She displayed significant signs of FAS with aggression such as growling, lunging, barking, hissing, snarling, and/or snapping.
(FAS = Fear, Anxiety, and Stress)
My favorite treats are:
*
Other things I enjoy that distract me during medical procedures are:
*
I prefer to be examined:
*
On the floor using a non-slip mat
In my owner's lap
On the table using a non-slip mat
In my carrier
Outside on a blanket/towel
Looking out the door/window
Things my owner can do for my next visit to make it even more fun:
*
Select All
Having me be a little hungry to make treats more exciting
Pheromones
Take me on a short walk prior to my appointment
Bring my favorite treats and/or toy
Bring a blanket or towel from home that smells familiar
Using prescribed pre-visit pharmaceuticals/nutraceuticals
My veterinarian suggests the following pre-visit pharmaceuticals/nutraceuticals:
*
The following training services are recommended:
Select All
Puppy Classes
In-home Training
Cooperative Care training
Fun Visits
Victory Visits
Visiting the Fear Free Happy Homes site for helpful information
Additional notes:
Δ
Home
About Us
Our Team
Services
Wellness and Vaccinations
Preventive Services
Medical Services
Surgical Services
Anesthesia and Patient Monitoring
Exotic Pet Medicine and Surgery
End of Life Services
Pet Health
How-To Videos
Pet Food Recalls
Product Recalls
Contact Us
Online Pharmacy
facebook