Information


In order for an optimal diet to provide real benefits, we need to ensure that your pet's gut is as healthy as possible. The information that you provide will help us to optimise your pet's diet to best support their health. Answer as much as you can - don't worry if you don't know the answer to each question. There are often more than one appropriate protocols which would suit each individual pet - information given to you from this form may sometimes differ from advice that you are given in store - let us know if you need any clarification. 


Contact Details
Date *
Date
Name *
Name
Phone *
Phone
Pet Information
Date of Birth
Date of Birth
If known
If known
De-sexed
If known
eg. A specific health condition; an interest in sustainable pet food etc
HEALTH
Does your pet suffer from any of the following issues?
Select as many as are applicable
How itchy is your pet?
How affected is your pet by joint pain?
Skip this question if not applicable
ANTIBIOTICS
If the answer is "No" please skip this section
OTHER MEDICATIONS
If possible, please include what the meds were for; and approximately when they have been prescribed
Please give details below