Pet Daycare/Boarding Application
The Pet Set - Atlanta, GA
Your Information
(*) Asterisk indicates a required field in order to submit.
Name
*
First Name
Last Name
Email
*
example@example.com
Cell Phone Number
*
Please enter a valid cell phone number.
Home Phone Number
*
Please enter a valid phone number.
Preferred Method of Phone Contact
Home Phone
Cell Phone
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Secondary Owner's Name
First Name
Last Name
Additional Names
Please list the First & Last names of people your pets may be released to. We will only release pets to you or your assigned agents.
Emergency Contact Name
First Name
Last Name
Emergency Contact Telephone
Please enter a valid phone number.
Pet Information
Please complete all fields for your pet's Personal Information
Pet Name
Pet Type
Dog
Cat
Color
Size
Mini
Small
Medium
Medium Large
Large
Giant
Sex
Male
Female
If Female, when was your Pet's last cycle
Breed
Weight
Pet's DOB
Is Your Pet Spayed/Neutered?
Yes
No
Does Your Pet have any of the following Identifications?
Microchip
Tattoo
None
Markings
Disabilities
If any
Describe your Pet's Interaction with people
Aggressive
Friendly
Shy
Bites
Other
If "Other" type of Interaction with people - Please describe
Describe your Pet's Temperament
Aggressive
Friendly
Shy
Bites
Other
If "Other" type of Temperament - Please describe
Does your Pet have any Behavorial Issues?
Yes
No
If your Pet has Behavorial Issues - Please explain
Has your Pet ever Bitten or been Bitten?
Yes
No
If "Yes" - Please explain
Has your Pet attended a Daycare before?
Yes
No
If "Yes" - When & where
If "No" - Type "N/A"
Has your Pet attended a Boarding Facility before?
Yes
No
If "Yes" - When & where
If "No" - Type "N/A"
Has your Pet attended Obedience Training?
Yes
No
If "Yes" - When & where. Please describe the outcomes of the Training.
If "No" - Type "N/A"
Does your Pet know Basic Commands?
Add all that apply: Sit, Stay, Come, Down, Fetch...
Is your Pet House Trained?
Yes
No
Is your Pet Crate Trained?
Yes
No
Health/Medical Information
Veterinarian Name
First Name
Last Name
Clinic Name
Clinic Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Clinic Telephone Number
Please enter a valid phone number.
Clinic Fax Number
Please enter a valid FAX number.
Allergies
Please list any known Allergies
Medications
Please list all Current Medications - Including the Frequency/Time Medication is administered
Date of of last complete Physical Exam
Date of last Fecal Exam
Rabies Vaccination Date Administered
Rabies Vaccination Due Date
DHLP Vaccination Date Administered
DHLP Vaccination Due Date
Parvo Vaccination Date Administered
Parvo Vaccination Due Date
Bordatella Vaccination Date Administered
Bordatella Vaccination Due Date
Heartworm Medication Date Administered
Heartworm Medication Due Date
What type of Flea & Tick Control methods are used?
Topical
Oral
Spray
Powder
Shampoo
Dip
Collar
Pet Daily Information
General information about your Pet's daily habits and lifestyle
Regular Brand & Variety of Food
Food Type
Wet
Dry (Hard)
Dry (Moist)
Frozen Raw
Freeze-Dried Raw
Other
Quantity of Food per Feeding
In cups, ounces, bowl, etc
List all Feeding Times
Regular Walking Times
AM? PM? AM/PM?
Exercise Instructions
Sleep Times
Typical Waste Elimination Times
Instructions, Concerns, or Special Needs
Client Signature
Owner's Electronic Signature (Please type your full name)
*
Clear
Today's Date
*
MM/DD/YYYY
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