Nutrition Consultations

This form is to be filled out prior to a nutrition consultation at Airdrie Animal Hospital.

Owner's Full Name *

Phone Number *

Address *

City *

Province *

Postal Code *

Email Address *

Pet's Name *

Birthdate

Age

Species *

Gender *

What are your nutrition goals and expectations for your pet? *

Current brand, diet and flavour of pet food *

Please provide the brand and full name of the diet.

If other, please state below:

Portion size (cups/grams per meal) *

Feeding frequency (meals per day) *

Feeding Method *

Portion controlled (specific measurements per meal)
Time-restricted (fed at specific times of the day)
Free fed (food is constantly available)

How do you store your pet's food at home? *

Does your pet have a good appetite? *

Yes
No
Sometimes

Have you noted any difficulties when your pet eats? If yes, please describe: *

Tell us about any treats or human foods your pet receives, how much, and how often *

Please provide as much detail as possible; including treat brands and flavours.

Additional comments

Let us know if there have been any recent changes to your pet's diet, eating habits or anything else you think we should know.

Is water available to your pet at all times? *

Yes
No

Do you think your pet is drinking... *

Excessively
Not Enough
Normally
I don't know

How is water offered? *

If other, please describe:

MEDICATIONS & SUPPLEMENTS

Does your pet receive any medications or supplements (including parasite prevention)? *

Yes
No

ACTIVITY LEVEL

Describe your pet's typical daily activity level: *

e.g. lethargic, sedentary, moderately active, highly active

Have you noticed any recent changes in activity level? If yes, please describe *

Tell us what your pet's typical day looks like: *

Where does your pet spend most of their time? What people live with your pet and are they involved in the feeding routine?

Nutrition Consultations

OWNER & PET INFORMATION

CURRENT DIET & EATING HABITS

DRINKING HABITS

MEDICATIONS & SUPPLEMENTS

ACTIVITY LEVEL

WEIGHT & BODY CONDITION

ROUTINES & HOME ENVIRONMENT

ADDITIONAL INFORMATION