Integrative Examination Form









  • What is your pet's main reason for seeking/needing holistic treatments?



Western Medicine History

If your pet was treated previously for this problem, please answer the following questions:




  • Please list to your best ability:





Traditional Chinese Medicine (TCM) History

Energy and Well-being:

Mobility

Pain

  • If you answered "yes", please complete the following regarding your pet's pain:

Nutrition/Digestion/Urinary

Skin

Reproduction

 

Breathing