Owner Information:
Pet Information:
What is your pet’s overall personality?
Does your pet have a preference for cool or warm places?
(activity/frequency)
(normal, increased, decreased, etc)
(normal, increased, decreased, etc)
(frequency, appearance, volume, odor)
(frequency, appearance, volume, odor)
(frequency, description)
(frequency, description)
(all the time? specific times of day?)

The Five Elements

Please check off any below that apply to your pet at any point in their life. (Don’t worry about the category titles right now. At your appointment, these will be explained in more detail.)

Fire
Normals
Abnormals
Wood
Normals
Abnormals
Earth
Normals
Abnormals
Water
Normals
Abnormals
Metal
Normals
Abnormals
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