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Consultation Request Form

For the best consultation experience, please take a moment to tell Dr. Roark about your animal and their condition.

About your Animal

Animal's Species (select one)

Animal's Sex (select one)

Your Animal's Condition

Have you been to your regular veterinarian with this animal regarding the condition of concern? If so, what was their diagnosis?

Have any tests or surgeries been performed on your animal? If so, what were they and what were the results?

Is your animal currently on any medications or supplements? If so, what are they?

What are you currently feeding your animal? Have there been any recent changes to the food?

Is your animal eating and drinking normally?

Is your animal urinating and defecating normally?

Are any other animals affected?

Have you already tried any essential oils for this condition, and if so what are they?

What brand of essential oils do you currently use?

Please describe the condition of concern in detail.

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