CNP Application

B2C - Clinical Nutrition Program

Professional intake form for the CANFELA Clinical Nutrition Program. Information submitted through this form will be reviewed by Dr. Mohammad Elahi to develop an individualized therapeutic nutrition plan based on the pet's confirmed veterinary diagnosis and available medical records."*" indicates required fields.

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This field is for validation purposes and should be left unchanged.

Contact Information

Name*

First Last

Email Address*

Phone / WhatsApp*

Pet Information

Pet Name

Age*

Species*

Dog

Cat

Other

Breed*

Neutered / Spayed*

Yes

Sex*

Male

Female

Current Weight (kg)*

Activity Level*

Low

Moderate

High

Not sure

Body Condition Guide

Please assess your pet while they are standing naturally. Look at your pet from above and from the side, and gently feel the ribs. Choose the description that most closely matches your pet’s current body condition.

For dogs: An ideal dog usually has ribs that can be felt easily without pressing firmly, a visible waist when viewed from above, and a gentle abdominal tuck when viewed from the side.

For cats: An ideal cat usually has ribs that can be felt with light pressure, a visible waist behind the ribs, and only a small amount of abdominal fat.

Which description best matches your pet’s current body condition?*

Use the Body Condition Guide above and choose the option that most closely matches your pet.

Very underweight: Ribs, spine, and hip bones are clearly visible from a distance. There is very little or no noticeable fat, and the body appears extremely thin.

Underweight: Ribs are easily visible or very easy to feel. The waist is very pronounced, and the abdomen appears noticeably tucked.

Ideal body condition: Ribs can be felt easily without pressing firmly but are not clearly visible. The waist is visible when viewed from above, and the abdomen has a gentle tuck when viewed from the side.

Overweight: Ribs are difficult to feel because of a noticeable layer of fat. The waist is less visible or absent, and the abdomen may appear rounded.

Very overweight: Ribs are very difficult or impossible to feel because of heavy fat coverage. There is no visible waist, and the abdomen appears broad or rounded. Fat deposits may be noticeable around the neck, chest, abdomen, or base of the tail.

Please note: This is an owner-reported estimate and is not a veterinary diagnosis. Your pet’s body condition will be considered together with the other information provided.

Veterinary Diagnosis & Medical Condition

Has your pet been diagnosed with a medical condition by a licensed veterinarian?*

Yes

A confirmed veterinary diagnosis is required for the Clinical Nutrition Program.This service is designed for pets with diagnosed medical conditions requiring therapeutic nutrition. If your pet has not received a veterinary diagnosis, please consider our Personalized Nutrition Plan instead.

What is your pet's primary diagnosed condition?*

Please specify the diagnosed condition*

When was your pet diagnosed?*

Date of veterinary diagnosis

Please describe your pet's diagnosis in your own words.

Please describe the diagnosis you received from your veterinarian, including the condition, severity or stage if known, and any important information your veterinarian provided.

Veterinary Examination & Medical Records

When was your pet last examined by a veterinarian?*

What type of veterinary records do you currently have?*

Please specify the diagnosed condition*

Upload Veterinary Records

Upload your pet's veterinary records, laboratory results, imaging reports, or previous medical nutrition records if available. Clear, complete files or photos are preferred.

Drop files here or

Max. file size: 512 MB, Max. files: 6.

Current Medications & Treatments

Is your pet currently taking any medications or receiving any medical treatments?*

Yes

Please list all current medications and treatments.*

Please include the medication or treatment name, dose, frequency, and how long your pet has been receiving it, if known.

Is your pet currently receiving any supplements?*

Yes

Please list all current supplements.*

Please include the supplement name, amount/dose, frequency, and brand if known.

Current Diet & Feeding History

What is your pet currently eating?*

Please provide the brand and exact product name for each food your pet currently eats.

How much food does your pet currently receive?*

Please provide the approximate amount of each food per day. If possible, include the weight in grams and the number of meals per day.

How many meals does your pet receive per day?

Current daily amount / feeding amount — Optional

Food transition history / reactions — Optional

How has your pet responded to the current diet?

Please specify

Nutrition Planning Preferences & Practical Availability

Please provide information about your nutrition goals, preferred feeding approach, available food options, budget, and daily routine. These details help us develop a nutrition plan that is not only scientifically appropriate for your pet but also practical and realistic for you to follow.

What would you like your personalized nutrition plan to help with?*

Select all goals that apply to your pet.

Please specify

Which feeding approaches would you be willing to consider?*

Commercial therapeutic dry food

Commercial therapeutic wet food

A combination of therapeutic dry and wet food

Commercial therapeutic food combined with home-prepared food

Home-prepared therapeutic food as part of the diet

I am open to any approach recommended by Dr. Elahi

Other

Select all approaches you would be comfortable considering. The final recommendation will be based on your pet’s medical condition, nutritional requirements, and the practical options available to you.

Please specify

What budget level would you prefer for your pet’s regular food?*

Budget-friendly — I prefer the most affordable nutritionally appropriate options

Moderate — I am comfortable with reasonably priced, good-quality options

Premium — I am willing to consider higher-priced options when justified

Flexible — I am open to recommendations across different price ranges

I prefer not to specify

Other

Please select the option that is realistic and comfortable for your household. This information will be used to provide practical recommendations.

Which pet food brands or products are available to you?

Please list brands or products that you can easily purchase in your country or region. Include dry food, wet food, or other products you are considering.

Do you have any preferred pet food brands or brands you would prefer to avoid? or Are there any foods or ingredients you cannot easily access?

Please explain any brand preferences, previous experiences, or products you do not wish to use. Please list any foods, brands, or ingredients that are unavailable or difficult to obtain in your country or region.

Are there any foods your pet refuses or strongly dislikes?

Are there any feeding limitations or preferences we should consider?

For example: preparation time, number of meals, food availability, feeding routine, or your pet's preferences.

Additional Information & Owner Notes

Please share any additional information that may help us develop a more accurate, practical, and personalized nutrition plan for your pet.

Is there anything else about your pet's health, medical history, diet, or previous treatment that Dr. Elahi should know?

You may include information about your pet’s appetite, food preferences, behavior around food, previous feeding experiences, daily routine, household situation, travel, practical limitations, concerns, expectations, and Please include any information that you think may be relevant, even if it does not fit into the questions above.

Photos & Supporting Documents

Please upload up to 4 files. To help us assess your pet’s body condition more accurately, please include:1. One clear, recent photo of your pet standing naturally, viewed from above. 2. One clear, recent photo of your pet standing naturally, viewed from the side.You may use the remaining upload slots for photos of the current food packaging, ingredient labels, veterinary reports, or relevant laboratory results.

Pet Photo Guide

Example showing how to photograph your pet from above and from the side

Please ensure that your pet’s full body is visible and that the photo is taken in good lighting.

Upload Photos & Supporting Documents

Drop files here or

Max. file size: 512 MB, Max. files: 4.

Please ensure that your pet’s full body is visible in both required photos. Avoid photos taken while your pet is sitting, lying down, curled up, or wearing bulky clothing.

Billing Information

Address*

Street Address City ZIP / Postal Code Country

Review & Payment

Please review your information before proceeding to payment. Once payment is completed, your request will be submitted for professional review.

Order Summary

Service
Clinical Nutrition Program

Delivery Time
Within 7 business days

Prepared by
Dr. Mohammad Elahi (PhD Animal Nutrition)

Total: €150

One-time payment • No subscription • Secure international payment

After clicking Proceed to Secure Payment, you will be redirected to our secure payment gateway to complete your purchase. Once your payment has been successfully verified, your clinical nutrition request will be submitted automatically.