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Pet Health Questionnaire

We have had a number of sample requests from Russia and the Balkan Countries. Please note that we do not send samples or sell products in this part of the world yet

Please use this form if you have questions relating to your pet's health or feeding, and we will endeavour to get back to you as soon as possible.

Please note: All fields marked with a * are mandatory

At the present time - we do NOT have a cat food!

1	Do you have a	Dog or a Cat *
2	Type or breed
3	Your Pet's Name
4	Your Pet's Age
5	Is your pet	Male or Female ? *
6	Has it been	Spayed or Neutured ?*
7	Weight of Animal	(in kgs)
8	Has your pet been diagnosed by a Vet?	Yes No *
9	If so what was the diagnosis?
	Questions 10 to 16 relate to possible symptoms, please tick all that apply.
10	Does your pet eat grass?
11	Does your pet chew its feet?
12	Runny eyes / build up of matter at the eyes?
13	Does your pet have dry skin like dandruff?
14	Is your pet constantly scratching?
15	Can you feel the animal's ribs?
16	Ear Problems / Wax Build Up / Ear Infection?
17	Pet shedding
18	Pet feeding?
19	Pet eating?	What do you feed at the moment?

	Name	Please supply your contact details below. *
	Address	*
	Telephone
	Email	*
	Comments

Please enter the number in the image above into the box below