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Research Interest Form

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Your Info

Your Name*

First Last

Email Address*

Your Pet's Info

Pet's Name*

Pet's Weight*

Pet's Date of Birth*

Pet's Gender*

Male

Female

Does your pet have any health conditions?*

Yes

No

Not Sure

If yes, please explain.*

How would you rate your pet's overall health?*

Very healthy

Healthy

Not healthy

Very sick

Do you walk your pet?*

Yes

No

If yes, how often?

Daily

Weekly

Monthly

Other

What pet food do you use?*

Please include the brand and type.

Does your pet take any supplements?*

Yes

No

If yes, what are they?*

Did your pet have any symptoms when their poop sample was collected?*

Yes

No

Not Sure

If yes, please choose from the list below:*

Please select all that apply.

diarrhea

loose stools

skin conditions

hair loss

paw chewing

low energy

aggression

in pain

constipation

How often does your pet visit a veterinarian's office?*

monthly

every three months

every six months

yearly

rarely

other

If other, please provide more info

Email

This field is for validation purposes and should be left unchanged.

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Innovative Pet Lab tests are designed to supplement in-clinic veterinary care. While they provide insight, they do not replace veterinary care or are intended to be individual diagnostic tools.

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