Home‎ > ‎

INFORMATION SHEET

Fill this out and bring with you when you drop your pet off                                                
OWNER’S NAME________________________________________________

ADDRESS______________________________________________________

CITY                                                   STATE                       ZIP___________________

HOME PHONE #                                                       CELL PHONE #_____________________

E-MAIL ADDRESS____________________________________________________________

EMERGENCY CONTACT NAME________________________________PHONE#______________

 

PETS NAME(S)                      BREED             SPAYED/NEUTERED       BIRTHDAY

____________________________________  ___________________    ________________

____________________________________  ___________________    ________________

____________________________________  ___________________    ________________

____________________________________  ___________________    ________________

 

BRAND DRY PET FOOD YOU USE________________________________________

BRAND WET PET FOOD YOU USE________________________________________

HOW OFTEN DO YOU FEED THEM_________________HOW MUCH _______________

  

ANY MEDICAL CONDITIONS WE SHOULD KNOW ABOUT

_______________________________________________________________________

_______________________________________________________________________

BORDETELLA (DATE)__________________      RABIES (DATE)__________________

 

HAS YOUR PET EVER SHOWN SIGNS OF AGRESSION?  _____YES       ______NO

IF YES, PLEASE EXPLAIN____________________________________________________

___________________________________________________________________________

HOW DOES YOUR PET REACT TO CHILDREN___________________________________

HOW DOES YOUR PET REACT TO OTHER ANIMALS_____________________________

 

VET YOU USE__________________________________________PHONE_________________

WE WILL TRY AND CONTACT YOUR VET IN AN EMERGENCY OTHERWISE IT WILL

BE THE VET OF OUR CHOICE.  YOU WILL BE RESPONSIBLE FOR ANY MEDICAL

BILLS INCURRED.

OWNER’S SIGNATURE____________________________________ DATE______________

Comments