Nutrition Consultation Form

Owner Information

Preferred Contact Method:

Sex:

What are you feeding right now? (List all that apply below.)

Dry/Kibble:

Raw:

Canned/Wet:

Home-Cooked:

Toppers/Mixers:

Feeding schedule (times + number of meals):

Favourite foods/treats/snacks:

Any known allergies or sensitivities?

If yes, list:

Check all that apply:

Stool quality:

Frequency of bowel movements:

Vomiting, gagging, burping, gas?

If yes, describe frequency or triggers:

Appetite level:

How often is water changed or topped up?

Current health concerns:

Past medical issues:

Current medications or supplements (with dose if known):

Energy level:

Meal setting:

Challenges around feeding time?

Do they eat with other pets present?

What motivated you to book this nutrition session?

What would success look like for you and your pet?

Anything else I should know about your pet’s feeding history, preferences, or home environment?

I understand that Kelly provides holistic nutrition consulting and is not a substitute for veterinary diagnosis or treatment. I agree to consult my veterinarian regarding medical concerns or major dietary changes.