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Canine Massage Therapy - Lifestyle Advice & Guidance -Exercise Programmes

Make An Appointment

So, you’ve decided that you want me to treat your dog. Complete the form below, and I will contact you to discuss your dog and confirm an appointment pending veterinary consent.

Your Details

First Name

Last Name

Phone Number

House Name/Number

Town

Postcode

Vet's Details

Registered Veterinary Practice

Branch/Town

Phone Number

Dog's Details

Name

Breed

Age

Date of Birth (If Known)

Gender

Neutered

Health

Please list any medications and/or supplements your dog is currently receiving.

Please list any significant accidents, injuries or surgeries your dog has had.

Reason for Treatment (Tick all that apply) * Required

Underlying Condition

Recovering from Injury

Maintenance

Pre- or Post-Surgery

Please list any significant accidents, injuries or surgeries your dog has had.

Environment

What activities does your dog take part in? (Tick all that apply) * Required

Walks (hard surfaces/around town)

Walks (mixed surfaces/parks/woodland)

Dog Sports

Ball Throwing

Running with Owner

Swimming

Approximately, how much exercise does your dog receive daily? Is this On or Off Lead?

What equipment is your dog walked in? * Required

Collar

Harness

Headcollar

Does your dog pull on the lead?

Does your dog live with other dogs? Do they play roughly?

Where does your dog sleep? * Required

Raised Bed

Sofa

Soft Bed on Floor

Round Plastic Bed

Crate

Your Bed

On Floor

Floor Surfaces at Home/Daycare * Required

Carpet/Rugs

Laminate/Wood

Tiles

Lino

Does your dog go upstairs?

Behaviour

Any recent changes in behaviour? Please describe.

Does your dog actively lick specific areas of their body? Where?

Any recent lameness/unusual movements/sensitive areas? Please describe.

I agree to the terms & conditions.View terms & conditions.

Thanks for submitting!

Not Sure Yet?

Please email me to ask any further questions you may have.

charis@train-and-treat.co.uk

charis@train-and-treat.co.uk
07531897185
North Tawton, Devon

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