Small Animal Intake Form Animal Intake Please fill out and submit this form at least 48 hours prior to your initial appointment. Required fields are marked with a red asterisk. The information you provide is held as private and will not be shared without your expressed permission. 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Has your pet ever bitten anyone? Has it ever displayed any aggressive behavior?* Yes No If yes, please explain.Is your pet comfortable being touched all over its body?* Yes No If no, please explain where they are not comfortable being touched and the reactions to doing so.Name of Veterinarian and Practice For reference only. I will not contact your veterinarian unless you specifically ask me to.Current Veterinary DiagnosisCurrent Medications: Please list by name with start and end dates of each medication.Healing Session FocusPlease take the neccessary time to consider the following question.What needs do you and your animal have that you would like to be addressed during the healing session?*How did you first hear about Earth Horse Healing?* Would you like be added to my email list?* Yes, please I'm already on your list No, thank you To receive occasional emails about events and class announcements. Δ