Consultation Form for Pets

Your Name

Email:

Address:

Telephone Number:

Describe the condition or situation regarding your pet which you would like to change with the help of our counseling service.

Is this condition of long duration or did it begin (or worsen) recently?

Tell us anything you know about your pet's history before (s)he came into your life.

How old was your pet when you got her/him? (known or estimated).

Describe how you got your pet (i.e., a stray, from a shelter, from a home, etc.)

Describe, if you remember, your first impressions of your pet. (It's helpful if you remember why you were attracted to him/her.)

How did your pet adjust to living in your house? (to a new living situation, people, other pets).

Who else lives in your pet's household at present?

How does your pet get along with them?

Describe your pet's general nature, i.e., aloof, timid, affectionate, demanding, hyperactive, etc. (The above isn't intended to limit you to one-word answers. Describe your pet as fully as you wish.)

If the pet's condition is of recent origin please tell us what changes have taken place recently, either for you or for someone else in your household (i.e., you moved, got another pet, a pet died, a baby was born, someone has been ill, etc.)

Often our companion animals mirror our own emotions; if you or another human in your household has been having emotional upsets lately please describe them.

Has your pet ever taken flower essences before? If so, which ones?

How did your pet benefit from these flower essences?

If there's anything else you'd like to say about your pet, please write it here.

I understand and agree that any information I receive from Joyce Kaessinger and/or Constance Barrett is not to be construed as directions, recommendations or prescriptions of any kind. Said information is not to be interpreted as a substitution for, or an addition to, medical advice, opinions, or treatment from a qualified physician. I agree to indemnify and hold Joyce Kaessinger and Constance Barrett harmless from any and all claims and from any and all loss, damage, liability or expense, including cost of suit and attorney's fees, resulting from or arising out of my use of said information for the above mentioned purposes.

email to: beyondtherainbow@hvc.rr.com

For mailing and payment instructions please see About Our Consultations

Mail to: Beyond the Rainbow, PO Box 110, Ruby, NY 12475