Resort & Spa Check-In Form: Dog Guest Information
Client Name:
First Name
Last Name
Date:
-
Month
-
Day
Year
Today's Date
Please fill out the following for each guest:
Guest 1
Guest 2
Guest 3
Name
Breed
Age
Color
Weight
Distemper/FVRCP (Date Due)
Bordetella/Kennel Cough (Date Due)
Rabies 1 yr, 3yr (Date Due)
Please select one of the options in the drop down menu for each guest:
Guest 1
Guest 2
Guest 3
Fecal Exam Due/Results
Negative
Positive
N/A
Negative
Positive
N/A
Negative
Positive
N/A
If your pet(s) is taking any medication, please specify the following for each guest:
Guest 1
Guest 2
Guest 3
Medication Name
Strength
Dose
Reason for giving?
Please fill out the following for each guest:
Guest 1
Guest 2
Guest 3
Food - Owner or Resort
Amount of Food
Frequency
Name of Food
If your pet(s) is physically handicapped, please select which applies in the drop down menu:
Guest 1
Guest 2
Guest 3
Blind
Yes
No
Yes
No
Yes
No
Deaf
Yes
No
Yes
No
Yes
No
Arthritic
Yes
No
Yes
No
Yes
No
Diabetic
Yes
No
Yes
No
Yes
No
Please select one of the options in the drop down menu for each guest:
Guest 1
Guest 2
Guest 3
Flea & Tick Check
OK
Pos
OK
Pos
OK
Pos
Additional Information:
Please select one of the options in the drop down menu for each guest:
Guest 1
Guest 2
Guest 3
Possessive of food or toys?
Yes
No
Yes
No
Yes
No
Gets along with other pets?
Yes
No
Yes
No
Yes
No
Gets along with people?
Yes
No
Yes
No
Yes
No
Ever bitten a person or animal?
Yes
No
Yes
No
Yes
No
Ever been bitten?
Yes
No
Yes
No
Yes
No
Likes to be petted?
Yes
No
Yes
No
Yes
No
Ever been boarded?
Yes
No
Yes
No
Yes
No
Vomiting when boarded?
Yes
No
Yes
No
Yes
No
Diarrhea when boarded?
Yes
No
Yes
No
Yes
No
Aggressive to handlers?
Yes
No
Yes
No
Yes
No
Frightened by loud noise/thunder?
Yes
No
Yes
No
Yes
No
History of seizures?
Yes
No
Yes
No
Yes
No
Bleeding disorders?
Yes
No
Yes
No
Yes
No
Urination problems?
Yes
No
Yes
No
Yes
No
Adverse reaction to Anesthesia?
Yes
No
Yes
No
Yes
No
Slow recovery from Anesthesia?
Yes
No
Yes
No
Yes
No
Please specify the following:
Guest 1
Guest 2
Guest 3
Any body part not to be touched?
Jumped a fence? If so, how high?
Any recent illness?
Date(s) of any recent illness?
Any long-term conditions or illnesses?
Any allergies to food or drugs?
Personal items?
Submit
Should be Empty: