Please fill out as thoroughly as possible so that an Iv San Bernard consultant can best assist you in creating a skin therapy plan. For best help, please include several well-lit photos of affected areas.

    Owner / Groomer Information

    First Name*

    Email*

    Phone Number*

    What is your relation to this pet?*

    If you are a groomer, are you part of the Pet Skin Academy Pet Aesthetician program?*

    Do you already have or use any Iv San Bernard products?*

    If you are not a groomer, are you working with a groomer that uses Iv San Bernard products?*

    If yes, what is your groomer's name and/or the salon name/location?

    Pet Information

    Pet Name*

    Pet Weight*:

    Pet Gender*:

    Pet Species*:

    If you selected "other", what is the species*?

    Pet's Breed*:

    Pet’s current diet (please include any treats/supplements and if there have been any recent
    changes in diet)*:

    Is The Pet On Flea/Tick Medication? If so, what brand and type (oral, topical, etc.)?*

    What Is The Pet's Current Bathing Routine (frequency and products used)?*

    Issue description

    Please describe issue in detail*:
    How long has this been going on?*

    Is this a seasonal issue?*

    Check all that apply:*

    Please describe odor, if applicable*:

    Please list areas of hair loss, if applicable*:

    Please list locations of sores, if applicable*:

    Specify "other"*:

    Pet Skin Photos (up to 6 images)
    Please make sure your photos clearly show any problem areas, full body and close ups of the pet/issue.* (Make sure they are able to upload up to 6 images).

    Allow our staff to use pictures for educational purposes

    Medical Information

    Has this pet been seen by a vet for this issue?*

    If yes, what, if any, was the diagnosis?

    Is the pet being actively treated by a veterinarian for this issue?*

    If yes, what treatments and/or medications are currently being used?

    Has bloodwork been done recently?*

    If yes, access to bloodwork results may be requested. If you have that available now, please attach below.

    Has the pet been seen by a specialist/Dermatologist?*

    Is the pet on any medications unrelated to this issue?*

    Please list medications, if applicable

    Has the pet been diagnosed with any other chronic issue, even if believed to be unrelated?*

    If yes, what was the diagnosis?

    *Disclaimer: This consultation form is intended for informational purposes only and does not constitute a diagnosis for your pet. Its primary purpose is to assist in formulating a plan of action based on the information provided. Please be aware that the accuracy and completeness of the details shared will directly influence the effectiveness of our recommendations. There may be situations in which we advise seeking veterinary assistance or testing for a comprehensive evaluation. It is important to note that the purpose of our recommendations is to contribute to the restoration of your pet’s skin, and our suggestions should not be considered a substitute for professional veterinary care.