New Client Form

Your Name (required)

Your Email (required)

Name of Animal Companion:

Age:

Sex:

Species:
 Cat Dog

Spayed/Neutered:

Breed:

Please list any ailments/illnesses affecting him/her, including symptoms and when they started:

Please list any known food or environmental allergies your animal companion has:

Please share your animal companion’s diet include brand of food, wet and/or dry, any homemade food and how long has he/she been on this diet:

How often do you feed your animal companion per day?

Do you give your animal companion any vitamins or supplements?

DISCLAIMER – PLEASE READ CAREFULLY
1. All Information provided by Holistic Healthy Pets by Jodi Z / Holistic Jodi, LLC (Holistic Jodi) and HolisticHealthyPets.net is designed for educational purposes. Holistic Jodi is not a veterinarian and thus does not diagnose, treat, cure or prevent diseases. Suggestions, advice, recommendations and other information provided by Holistic Jodi via products, services, newsletters and consultations are not veterinary advice and are meant to help animal caretakers make educated and appropriate choices for their animal companion. Information and/or recommendations from Holistic Jodi are provided for educational or reference purposes only and is not a substitute for veterinary care.
2. Always contact your veterinarian if your animal companion is ill, has an emergency or an accident.
3. Holistic Jodi is not beholden to, and does not profit from, any products recommended to clients. The client is encouraged to purchase products directly. If the client requests, Holistic Jodi will place and deliver orders for client convenience purposes only.
4. Holistic Jodi does not warrant the performance of any products due to numerous variables (animal genetics, diet, emotional state, health, drugs, vaccination and surgical history, environmental toxins, individual sensitivity and vitality – to name a few).
5. The Client agrees that no liability, no warranty or guarantee of a cure is expressed or implied with any information provided by Holistic Jodi.
6. Information and services provided by Holistic Jodi are not intended to replace proper pet health care from registered veterinarians, veterinary surgeons, pet psychologists, pet behaviorists or other pet care professionals. The client understands that whenever using non-veterinarian prescribed products and services, including Holistic Jodi, they do so at their own risk. It is up to the client to take their pet to a veterinarian for proper diagnosis and treatment.
7. The client understands and agrees that Holistic Jodi shall not be liable for any direct, indirect, incidental, consequential or exemplary damages to any animal companion.
8. By submitting this completed form to HolisticHealthyPets.net, you are agreeing to these terms.