Flower Essence Consult Form for Dogs or other pets
Your Name:
Mailing Address (Street, City, State, Zip):
Email:
Telephone Number:
If I have follow-up questions to this form, do you prefer to be contacted by email or phone? If phone, please provide some good days and times to reach you.
Name of Pet:
Species & Breed(s):
Age Acquired:
Age Now:
Male or Female:
Spayed/Neutered? (If yes, at what age?)
Where did you learn about Aldaron Animal Essences?
Please note: For the following questions, it is most helpful if you can describe the behavior itself in as much detail as possible, as well as your interpretation of your pet's emotional state at the time. Don't worry about using technical terms; just describe what is happening to the best of your understanding.
Please describe the behavior, condition, or situation regarding your pet which you would like to change with the help of this consult. If there are several issues, list in order of priority.
Approximately how long has it been going on? Has it worsened recently?
How do you respond to your pet when s/he displays the behavior? Has this changed over time? Please explain.
Describe how you got your pet (i.e., as a stray, from a breeder, from a shelter or rescue organization, from a private home, etc.)
What were your initial impressions of your pet, upon meeting him/her? What attracted you to this animal?
Tell me anything you know about your pet's history prior to living with you.
If you have had opportunity to observe how your pet adjusts to new situations, new people, and other animals, please tell me about it.
Who else does your pet lives with? Who does he interact with on a regular basis? (Include people and other animals.) How does your pet get along with them?
Regarding the behaviors of concern, is the behavior more or less severe when with other family members?
Describe, as fully as possible, your pet's general nature. This is your pet's personality on a day to day basis, not necessarily when in the situation that is of concern. If your pet's personality has changed since the issue of concern began, what was s/he like before the change?
If your pet's condition began recently, are there household or other life changes that have taken place during that time frame, for the pet, for you, or for someone in your home?
Dogs are easily affected by our emotions. This can take the form of mirroring, such as showing anger when we get angry, becoming afraid themselves when we are in situation that make us nervous, or an opposite, balancing type of reaction, such as becoming bold and protective when we become nervous or unsure, or submisssive and uncertain when we behave in an loud or agitated fashion. If the behavior(s) of concern appears to be related to your emotional state or reactions, please discuss that here.
Has your pet ever taken flower essences before? If yes, which ones?
How did your pet benefit from these flower essences?
If you can think of anything else that might be useful for me to know about your pet, please include it here.
Thank you for taking the time and effort to fill out this form as thoroughly and thoughtfully as possible. Your detailed information makes it possible for me to prepare the most helpful formula for your pet!
Please send your completed form via email to: juliec@aldaronessences.com
In the email subject line, put "Flower Essence Consult".
You can also mail your form and payment ($49 for consult + 1 ounce custom formula) to:
Canine Behavior Services, 1131 Oak Hill Road, Roseburg, OR 97471
**Please be sure to make your check out to Canine Behavior Services**
Home : Flower Essence Formula Line : Consults and Custom Formulas : Flower Essences Information & Resources : About Aldaron : Contact