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Intake Questionnaire

About You

About Your Animal

Sex
Male
Female
Spayed/Neutered
Yes
No

Your Animal's Health

Disclaimer

Please note that Susanna Anthony is not a veterinarian and does not offer medical diagnoses. Any suggestions should be discussed with your veterinarian. Susanna aims to teach her clients how to care for their animals in a more natural, holistic manner and concentrates on improving the animal’s nutrition. She advises to always consult with a veterinarian and if possible, have diagnostic work done before a consultation with her. An accurate diagnosis is sometimes necessary to determine the best natural care options for an animal.


By signing this document, I confirm that I have read and understood the statement above and waive and release Susanna Anthony from any and all liability, past, present and future, relating to the services provided by her to me and my animal(s).

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