Acupuncture Patient Questionnaire

PLEASE COMPLETE THIS QUESTIONNAIRE PRIOR TO YOUR INITIAL EVALUATION.

Client Name *
Client Name
Address
Address
What is your pet’s overall personality?
Does your pet have a preference for cool vs warm places?
Dry kibble or canned food? What type of protein/meat source?
Does he or she drink small frequent amounts or large volumes at once?
Normal formed, pudding like, hard and dry?
Short frequent or large and long?
Any particular time of day?