Intake Form – Clovis & Company

Answers to these questions help me learn a little bit about you and your dog and get started on formulating a recipe, or evaluating your current homemade recipe for your dog. (There is currently a waitlist for services.) Thank you for taking the time to provide me with this information! After I receive your intake form I will follow-up with you. Please check your spam folder if you don’t get a response within 24 hours; thank you!

(Services are listed here, and are for healthy adult dogs.)

Your Name *

First

Last

Email Address *

Location *

City/State/Country

Dog's Name *

Dog's Age *

Breed *

Does your dog have any health concerns? *

Please check the two that apply. *

Female
Male
Spayed/Neutered
Intact

How much does your dog weigh? *

Is your dog at an ideal weight? If not, what is your dog's goal weight? *

Is your dog very active or a couch potato? Please describe your dog's activity level in detail. *

What does your dog eat exactly? How much? How long on this food? Please provide as much detail as possible. *

Do you give your dog any supplements or medications? *

If yes, please list which ones.

Please describe your feeding philosophy and goals with home-prepared food for your dog. For example, do you want to feed it all the time? 50% with commercial food? Do you have a strong preference for or against raw or cooked, or grains or grain-free? *

Please include anything else you think may be pertinent.

What ingredients/foods does your dog like, and you are willing/able to provide? *

If you could list at least one meat and veggie here that would be very helpful.

Are there any ingredients/foods that your dog can not have (either due to dislike or a allergy/sensitivity)? *

Please list them here and the reason, or send via email if you have allergy test results.

Do you prefer to buy nutritional supplements online, locally, or no preference? *

If you have a preferred website please specify.

What size batches of food would you like to make? *

Can be in terms days for recipe to last, or weight of food to prepare at once.

Do you consider yourself new to home-prepared food for dogs? *

Yes
No
Somewhere in between

Is there someone or group we can thank for the referral?

Additional Comments

Please use this space for any additional information you'd like to provide.

Client is responsible for all risks associated with home-cooked or raw foods. Services provided by Lindsay Hadfield/DBA Clovis & Company are not a substitute for veterinary care, nor do we make any health guarantees. Recipe formulations may not be shared with anyone, except your vet, without written permission. Client understands the importance of storing supplements out of reach of pets and children. *

Please initial above if you agree.

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