Surveypoint

Q1

First Name

Full Name*

Q2

Last Name

Full Name*

Q3

Primary Phone Number*

Q4

Pet's Name:*

Q5

Have something you want to show us? Add it here!

Q6

When did your pet start experiencing symptoms?*

Q7

What exactly are you seeing at home?*

Q8

If your pet is having diarrhea, approximate how many times per day:

Q9

Describe the diarrhea (large puddles, small droplets, blood in it, any mucous, etc):

Q10

Stool Quality Score*

Please Select

1

2

3

4

5

Q11

If your pet is vomiting, approximate how many times per day:

Q12

Describe the vomit (large puddles, small foamy vomit, blood in it, etc):

Q13

Have you brought a stool sample today?*

Yes

No

Q14

What changes have you noticed in your pet’s personality or behaviors?*

Q15

What diet is your pet currently eating?*

Q16

Please upload pictures of any food, treats, medications or supplements your pet is currently taking:

Q17

How long has your pet been on this diet?*

Q18

What table scraps/homemade cooking or treats does your pet get?*

Q19

When was the last bag of food opened?*

Q20

Does your pet... (your opinion)*

Drink too much water

Drink the right amount of water

Not drink enough water

Q21

Is your pet peeing more than usual?*

Yes

No

Q22

Have there been any recent accidents in the house?*

Yes

No

Q23

Does your pet attend grooming/boarding/daycare/dog park facilities?*

Yes

No

Q24

Does your pet hunt?*

Yes

No

Q25

Does your pet roam freely outdoors?*

Yes

No

Q26

Does your pet eat feces/drinks outdoor water from wildlife/other pets/its own?*

Yes

No

Q27

Does your pet have possible access to the compost/garbage/recycling?*

Yes

No

Unsure

Q28

Is there a chance your pet ingested a foreign object (sock, toy, medication, etc)?*

Yes

No