Initial Consultation Behavior History Form

Initial Consultation Behavior History Form

Initial Consultation Behavior History Form

Initial Consultation Behavior History Form

PLEASE NOTE: WE MUST RECEIVE THIS COMPLETED FORM PRIOR TO SCHEDULING YOUR APPOINTMENT.

Welcome to Heart of Chelsea Veterinary Behavior Medicine Service! We understand how stressful behavioral difficulties in our pets can be, and we are here to help. Our doctors have years of experience treating a wide variety of behavioral concerns – you name it, we’ve likely seen it (many times!) We understand how isolating and scary it can feel to have a pet with behavior concerns, but we are happy to let you know there are many options for treatments to help improve the quality of life for both your pet and your family.

Your appointment Location: 

257 West 18th Street, New York, NY 10011

What to expect at your initial appointment:

Our initial behavior appointment will be 90 minutes long. If your pet already has medications that you know help keep him or her calm during veterinary visits or in new locations, please give those medications 2 hours prior to leaving your home for your initial consultation. This is a long visit and we do not want your pet stressed the entire time.

WE DO NOT NEED TO SEE THE BEHAVIOR TO BELIEVE OR UNDERSTAND WHAT IS HAPPENING!

We would rather your pet be as relaxed and comfortable as possible as we review the history and treatment plan. Many behavioral diagnoses and assessments are based off verbal history and discussion.

During our appointment we will:

  • Briefly review the history form you will fill out below.
  • Review your goal list (to assure we are all on the same page with what you hope to achieve)
  • Review the behavioral diagnoses for your pet, as well as the prognosis and estimated timeline for improvement.
  • If it is safe and comfortable for your pet, we will perform a physical exam. Otherwise, we will perform a distance exam to establish the legally required Veterinary Client-Patient Relationship (VCPR)
  • Discuss a 3-part treatment plan:
    • Medications and/or Supplements – if they are indicated for your pet, how and why they can make a difference, what we are looking for to indicate improvement, possible negative side effects or risks.
    • Behavior Modification and Training – including recommendations for trusted trainers if you are not already working with one. We like to say that a behavior focused veterinarian is like the psychiatrist, and the trainer is the therapist. They often work as a team to help develop a comprehensive treatment plan for your pet.
    • “Client Homework” – safety management and how to set your pet and their environment up for success.
  • Please note we will always advocate for positive training methods, as science tells us this is by far the most successful long term. It is important to know that the success of your pet is directly dependent on your involvement and implementation of their treatment plan.

What to expect AFTER your initial appointment: 

We know you might feel overwhelmed with information on your first visit, therefore, we will send you a treatment plan summary for you to reference after each appointment. In addition, we generally expect most families to require case follow up every 4-6 weeks. These visits will be virtual (by telephone) for 6 months from the date of your initial appointment.

  • At the 6-month mark, if we have not seen your pet in person for other reasons (such as medical care or wellness care), we require an in person visit to maintain the veterinary client-patient relationship.
  • Prior to each follow-up visit you will receive a brief follow-up history form to help give us a brief update on how things are going (Don’t worry- these forms are much shorter than this initial form and should only take a few minutes to complete!)
  • Each follow up virtual visit is 30 minutes long (45 min for in person), during which we discuss how things are going, and based on your updated history we decide how to adjust the treatment plan. 
  • Total length of treatment varies greatly, depending on severity and quantity of behavioral concerns, owner commitment to treatment, your pet’s response to medications, among other things.
  • Like human psychiatry, progress is not linear – there are often ups and downs, but our goal is that we are generally moving in a positive direction.

Please note, the more information you share in this history form, the more time we will have during our initial appointment to review treatment plans and answer questions (rather than clarify case history!) 

  • Plan to dedicate at least an hour to filling out this form. 
  • We recommend having all family members and those that know your pet well (e.g. pet nannies) participate in completing this form so we can have the most comprehensive history of your pet’s concerns. 
  • For any section which you feel may apply to your pet but is only a mild concern, please still mark YES, and answer the subsequent questions, as this will help the doctor assess whether the concern should be addressed. 
Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country
Would you like to add a secondary contact to the account?

Secondary Contact Information

Name
Name
First
Last

Pet Information

(If unknown, approximate age)