CLIENT INTAKE FORM

Dog's Name

Dog's Date of Birth

Owner's First Name

Owner's Last Name

Street

Suburb

Postcode

Email Address

Phone

Breed

Sex SexMaleFemale

Desexed Yes/No Desexed Yes/NoYesNo

If yes, what age?

How did you find out about our services? How did you find out about our services?Google MapsGoogle SearchFacebookInstagramWord of MouthReferralCar Signage

If you found us through Google Search would you mind sharing which words you typed into google, otherwise enter n/a

If you were referred to us please provide their name, otherwise enter n/a

What is your dog's activity level? What is your dog's activity level?LowMediumHigh

What walking restraint are you using? What walking restraint are you using?CollarHarnessHaltiMostly Off Lead

How often do you walk your dog and for how long?

Is your dog involved in any sport (i.e. agility, confirmation, scent work, tracking, etc)?

Where does your dog sleep (i.e. inside/outside, kennel/crate, bed, couch, etc)?

Diet/Nutrition (i.e. dry food, wet food, raw feeding, combination, etc.)?

Vet name and address

Last vet visit

Current medication administered

Current supplements administered

Please tell us your reason for engaging Paws4Paws

Please tell us about any injuries and/or medical conditions your dog has had in the past and/or currently has (i.e. arthritis, hip/elbow dysplasia, spondylosis, lumbosacral disease, IVDD, cruciate ligament injury, tendonitis, muscle strain, luxating patella, etc.).

Does your dog have any difficulties lying on their front, back or side? Does your dog have difficulties/is reluctant/hesitant to jump in/out of a car, or climb/descend stairs? If so, please provide further detail.

Has your dog’s behaviour changed in any way (i.e. less social, less playful, anti-social, aggressive, lethargic, etc.). If so, please provide further detail.

Is there any particular area where you think your dog is experiencing stiffness; tension; discomfort or pain? If so, please provide further detail.

Do you feel your dog is currently under stress? If so, please provide further detail.

Is there anything else about your dog’s health and/or behaviour that would be useful for our therapist to know?

Client Consent Client Consent I understand that the services provided by Paws4Paws include the assessment, treatment, and rehabilitation of musculoskeletal, neurological, post-operative, age-related, and mobility conditions in dogs. I acknowledge that Paws4Paws does not diagnose illness or disease, nor prescribe medications. I have informed Paws4Paws of all known medical conditions affecting my dog, as well as any medications, supplements, or herbal remedies currently being administered. I agree to keep Paws4Paws informed of any changes to my dog's health status, medications, diagnoses, or medical history.

Cancellation Policy and Late Payment Fees Cancellation Policy and Late Payment Fees Due to the nature of our mobile, in-home service and the travel involved in providing appointments across Melbourne and Geelong, we require a minimum of 48 hours' notice for any appointment cancellations or rescheduling requests. To keep our fees as reasonable as possible, appointments are grouped by geographic area and carefully scheduled to minimise travel time. Advance notice allows us to offer the appointment to another client and adjust existing appointments to maintain an efficient schedule. For this reason, cancellations or rescheduling requests made with less than 48 hours' notice will incur an $80 fee. Payment is due within 14 days of the invoice date. Late payment fees may apply to overdue accounts.