Sacred Paws
“Animal Natural Health & Behavior for Mind, Body, & Soul”
Dr. Stephanie R. Smith, DAN, CDBC, CCDT, CPCN
Doctor of Animal Naturopath, Animal Communicator, Reiki Practitioner, Certified Dog Behavior Consultant,
Certified Professional Canine Nutritionist, Certified Herbalist & Homeopath
& Trauma Informed Positive Reinforcement Dog Trainer
Intake
| Your Name(s) | Address | Phone Number | |
| How did you hear about Sacred Paws? | |||
| Your Animal’s Name(s) | Species/Breed | Male/Female | Weight | Age | |
| Other Animals in Home (Name, Species, Sex, Breed, Age): | Herbs, Allopathic(s), Homeopathies or Other Current Medications: | ||||
Does your animal have food allergies/sensitives? ____________________________
What behavioral issues is your animal experiencing? __________________________________________________________________________________________________
What herbal, nutritional, homeopathic, energetic, or other natural health hurdles are you experiencing?
__________________________________________________________________________
What are your goals for you and your animal(s)? _____________________________
_________________________________________________________________________________________________
What days and times work best for sessions? _____________________
__________________________________________________________________________
Signature: _________________________________ Date: _______________