Individualized Petessiance Formula consultation form

Individualized Petessiance Formulas

Do not complete this Individualized Petessiance Formula form until you have
Purchased Personalized Pet Essence Remedy

When your Individualized Petessiance Formula has been purchased you will be given the link back to this form page.

This consultation form will not be evaluated until you have purchased the Individualized Petessiance Formula.

Once you have Purchased Personalized Pet Essence Remedy submit your individual pet's information using the evaluation form (below). Dr. Jean reviews the information, then uses her experience and intuition to select the most appropriate remedies for your animal companion.

All emotional, behavioral, and physical issues have an energetic root that can be addressed with essence remedies.
Some of the common problems we encounter include:

Spraying and litter box problems in cats
Marking and inappropriate urination in dogs
Failure to adjust to household changes
Jealousy or aggression
Separation anxiety
Excessive vocalization
Fearfulness
Hyperactivity
Overly stressed when boarded or confined
Grief due to loss of animal or human companion
Acceptance of new animals or people
Travel anxiety
Training difficulties
Performance difficulties in show or racing animals
Recovery from illness or injury
Coping with chronic diseases
........and many more

All of these problems can be modified, and in many cases resolved, with flower essences. Additionally, because Dr. Jean is a veterinarian and certified behavior consultant, she knows when to advise you if other assistance, such as a veterinary examination, medical tests, or professional training, may be necessary or would be advantageous.

The cost for a personal consultation is $65.00, which includes your first 1-ounce bottle of Petessiance Individual Formula, handling fee, and shipping. Refills of your Individal Formula are $20.00 including handling fee and shipping.

Individualized Formula Consultation Form

NOTE:	If you wish to order individualized remedies for more than one animal, please fill out a separate form. Fill it out completely for each animal to be treated.
* Required Information

*Your Name:
*Your email address:
*Street Address:
*City:		*State:	*Zip:
*Home Phone: (Necessary for follow-up)		Mobile Phone:

*Animal's Name:		*Species:
*Breed:		*Approx. Age:
*How old was the animal when you got it?:		*Where did you get it?:	*Spayed or Neutered?:
*If cat, declawed?:		If yes, declawed at what age?:	Front only or all four paws?:
*Other animals in the household? Please list species, gender and age of each: (One line per animal, please.)
*Last examination by primary care veterinarian (date):
*Please note any relevant findings or diagnoses:
*Last vaccinated (date):		*Vaccine(s) given:
*Has the animal ever had any major surgeries, illnesses, or injuries?
*Please describe the problem or problems: When did it start, has it gotten worse with time, what circumstances do you feel trigger or contribute to the problem, what would you like to have happen to resolve the problem, etc. Take your time, and give as much detail as possible. (This area is extremely important!)

The cost for a personal consultation is $65.00, which includes your first 1-ounce bottle of Petessiance Individual Formula, handling fee, and shipping. Refills of your Individal Formula are $20.00 including handling fee and shipping.
Please Note: I understand and agree that any information I receive from Dr. Jean Hofve, Petessiance, or Ojibwa Tea of Life, is not to be construed as veterinary advice or prescriptions of any kind. Said information is not a substitution for veterinary care or other treatment from a qualified professional. I agree to indemnify and hold Dr. Jean Hofve, Petessiance, and Ojibwa Tea of Life 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.