2020/21 Questionnaire: PART II - Skin Conditions Please enable JavaScript in your browser to complete this form.Title (optional)MrMrsMissMsRather Not SayName (optional)FirstLastEmail (optional)Address (optional)Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPet Name of Fauve (optional)Kennel Club (KC) Registered Name of Fauve (optional)Current Age of Fauve *Age of Fauve When Condition First Noticed *Dog or Bitch? *DogBitchIs your Fauve Neutered? *YesNoHas your Fauve Been Used for Breeding? *YesNoDoes your Fauve have annual vaccinations (e.g. Leptospirosis / Kennel Cough)? *YesNoPlease indicate each skin condition or symptoms your Fauve suffers from *Hair LossFoul OdourInflammation/RednessItching/ScratchingOtitis/Ear InfectionsLicking/ChewingSkin Sores/LesionsSkin Changes (colour/texture)OtherIf "other" selected, please provide more information: Please indicate for each skin condition or symptom selected its severity on a scale of 1 least severe to 10 most severe (e.g. Hair Loss 3 & Licking/Chewing 4) *Condition Diagnosed by Vet? *YesNoIf condition diagnosed by Vet, please provide more details:Does your Fauve also suffer with other illness in addition to the skin condition(s)? *YesNoIf "yes", please provide more information: Is the skin condition permanent or intermittent (e.g. seasonal)? *PermanentIntermittentDuring which seasons or months does the condition occur or worsen (if at all)? *If your Fauve suffers itching/scratching, does this occur gradually or is it triggered suddenly? *GradualSuddenNot ApplicableIf your Fauve suffers skin sores/lesions, do they occur before any itching/scratching or after any itching/scratching or do they occur simultaneously? *BeforeAfterSimultaneousNot ApplicableHas your Fauve suffered any behavioural changes? *YesNoIf "yes", please provide more information: Is your Fauve on a flea/tick preventative treatment? *YesNoIf "yes", please confirm product & frequency of treatmentIs your Fauve on a worming preventative treatment? *YesNoIf "yes", please confirm product & frequency of treatmentPlease indicate the type of food most regularly fed to your Fauve *Dry/KibbleWet/TinnedRawOtherIf "other" selected, please provide more information:Please confirm food brand & type (if applicable) - e.g. Arden Grange Lamb & Rice kibble *Please outline any changes made to your Fauve's diet because of the skin condition(s) including any supplements you provide to your Fauve (if applicable) *As a result of the skin condition(s), how do you rate your Fauve's quality of life? *ExcellentGoodFairPoorVery PoorSubmit