(480) 420-3712 [email protected]

Screening:

Contact Info:

Do You Currently Have A Pet? *

Which Type Of Pet Do You Have? *

If Other, Mention Which Animal *

What Is The Name Of Your Pet? *

What Is Its Breed? *

What Is Its Age? *

What Is The Gender Of Your Pet? *

Have You Experienced Any Major Event In The Past Year That May Have Caused You Any Psychological Distress?*

In The Past Few Weeks, Have You Lost Interest In Things That You Generally Find Interesting? *

In The Past Few Weeks, How Often Have You Felt More Angry And Agitated Than Before? *

Do You Feel Pessimistic And Discouraged Or Depressed About Your Future? *

In The Past Few Weeks, Do You Feel Like Staying At Home A Lot And Experience Social Anxiety? *

How Often Do You Get Anxious And Worried? *

How Often Do You Feel Yourself Beaten-Up By Life? *

Please Explain How You Feel When You Are Stressed. *

List Any Prescription Medications You Take. *

How Does Your Pet Offer Emotional Support To You? *

Do You Want To Fly With Your Pet In-Cabin? *

Are You And Your Pet Looking For A New Place To Live? *