Nutrition Consultation Questionnaire

* Indicates required field

Name *

First

Last

Phone Number (Cell Preferred) *

Email *

Name of Dog *

How long have you had your dog? *

Age/Breed of Dog *

Any recurring health issues? Please list in detail (how long have they been occuring, treatment, etc. This information will help us create a nutritional plan that helps better support your dog from the inside out). *

What are you currently feeding your dog (type/brand of food, how much)? *

How does your dog eat their current food (slow and methodical, picks at it, scarfs it down)? *

Approximately how much are you currently spending per month on dog food? *

Where do you currently purchase your dog food? *

Has your dog ever shown any guarding or aggressive behavior around food? *

Yes No

Anything else you'd like me to know about your dog? *

Please describe your dog's temperament. (For example, is s/he always friendly? Aloof/independent? Anxious or relaxed? Active or likes to lay low? A cuddle bug or prefers own space? Prefers warm or cold temperatures? Any behavior issues? This information will help us select a food that supports your dog's constitution.) *

What is your approximate budget for dog food (want to spend the same, spend less, willing to spend a little more)? *

Do you have other pets in the house? If so, do they eat the same or different diets? *

What is your dog's most current weight? *

Would you say your dog is at their target weight, a little overweight, or a little underweight? *

Thank you for taking the time to complete this questionnaire and I look forward to working with you!

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Nutrition Consultation Questionnaire

Helping dogs & people find balance through compassionate behavior modification, personalized training, and holistic nutrition consulting across Savannah, Pooler, Bluffton, Statesboro, Richmond Hill & surrounding area.