Step 3 of 4

Your pet health questionnaire

This takes a few minutes, and payment comes straight after it. The laboratory reads the result against what you tell us here rather than against an average, so these answers are what turn a column of numbers into something your vet can work with.

Where this sits

Prepare your animal's hair sample.
Send it to Brunswick Health Hair Mineral Testing, 1/68 Melville Road, Brunswick West VIC 3055 — or drop it at reception.
Complete this questionnaire. You are here.
Finalise your submission — this form takes you to payment when you send it.

Analysis begins once all four are done, and the report is emailed to you 3 to 4 weeks from the day we receive the sample. Full collection instructions are on the hair mineral testing for dogs and horses page.

About you

Your full name (required)

Use the same name when you pay. That is how your questionnaire, your sample and your payment are matched to each other — so if the card is in someone else's name, put your own name here and pay under it too.The owner's name, not the animal's — there is a field for that below.

Order reference (only if you have already paid)

Leave this blank if you have not paid yet — payment is the next step, and most people get here before it. If you have already paid, the reference starts with BH- and is at the top of your receipt email.

Email (required)

This is where the report is sent.

Mobile (required)

Only used if something about the sample needs sorting out before it goes to the lab.

Street address (optional)

Suburb (optional)

State (optional)

Postcode (required)

About your animal

Your animal's name (required)

Dog or horse (optional)

Breed (optional)

Age (optional)

Sex (optional)

The sample

Date you cut the sample (required)

The window a sample represents is counted back from the day it was cut, so this matters more than it looks.

Tested this animal before? (optional)

Previous lab number (optional)

Date of that report (optional)

Both are on an earlier report, if you have one to hand. They let the laboratory read this result against the last one instead of on its own.

Medications and treatments

Anything given by mouth or injection (optional)

Anything applied to the coat or skin (optional)

Worth listing even if the sample was cut well away from where it went on — several of these carry the elements being measured.

Why you are testing

What prompted you to order this (required)

The most useful box on the form — it is the first thing read alongside the numbers.

Anything else worth knowing (optional)

Before you send this

I understand that Brunswick Health cannot give veterinary advice or interpret my animal's results, and that the report is for my vet to read. I understand that hair mineral analysis is a screening tool intended to be interpreted alongside my animal's full history, and that the results are not a stand-alone diagnostic test and should not be used to make isolated conclusions about nutrient deficiencies or heavy-metal exposure.I am aware a 20% administration fee applies to cancellations made before laboratory analysis begins, and that once analysis has started the test cannot be refunded. I am happy for my answers to be handled as set out in the privacy policy.

Or call (03) 9380 8099 and do it over the phone.

What happens to your answers

They go to the clinic and travel with your sample to the laboratory, over an encrypted connection, and they are not sold or shared outside the practice.

Full privacy policy