LOST ANIMAL

~ Communication Booking Form ~

Name of Animal ............................................................................

Animals Age: .................................................................................
Gender: ..........................................................................................
Species/Breed: .............................................................................
If spayed/neutered/entire: ............................................................
How long has the animal lived with you: .................................................

Your Name ............................................................................................................................................................
Address ..................................................................................................................................................................
..................................................................................................................................................................................
Email .......................................................................................................................................................................

Telephone .............................................................................................................................................................

Is this the usual home location of the missing animal? Yes/No: .......

If alternate location, please detail: .............................................................................

Post code: ....................

Date & time animal last seen: ..................................................................................

Occasion & whereabouts last seen: .........................................................................

Wearing collar when last seen: Yes/No.......... Micro-chipped: Yes/No.................

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The following are points I address as questions, when working with lost animal situations, these are then elaborated on further depending upon an animals initial response:

Determine status alive/passed over; Are you inside/outside (describe); Are you able to move freely/or stuck/restricted (describe); Are you high up from the ground; Describe/convey texture under foot; Noises in vicinity; Scents/smells/odours in vicinity; Is a person caring for you (describe); Have you travelled in a vehicle since leaving home (describe); Are other animals around you (describe); Describe approaching the location where you are now; Describe your surroundings.

Optional questions ~ please indicate if you would like me to include the following questions:

How are you physically/mentally? Ask: Yes/No: ............

Why did you leave home? Ask: Yes/No ..............

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Please detail any further questions or messages you would like conveyed to your animal during the session:

......................................................................................................................................

......................................................................................................................................

I confirm the above named animal is my personal responsibility and I have requested a Lost animal communication session. My payment of £35 which I understand is at lesser rate than a regular AC session (payable to Jane Summers) is enclosed / forwarded via Paypal (click 'donate' button; see menu: Booking & Cost).

Signed:....................................................................................Date:...............................

Please send to:

Jane Summers Animal Communicator E: summersjanieuk@aol.com
Paint Horse Cottage
23 High Road
Needham.
Norfolk.
IP20 9LB.

Telephone 01379 855003 www.talktotheanimals.co.uk