Lucky Penny K9s & Felines
Pet Information Form
Client Name
*
First Name
Last Name
Pet Name:
*
Breed:
*
Species
*
Canine
Feline
Other
Approximate Date of Birth
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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Day
Please select a year
2025
2024
2023
2022
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2020
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2014
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2012
2011
2010
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2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
Year
Sex:
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Male
Female
Spayed or Neutered:
*
Yes
No
No - my pet is too young at this time
Not applicable due to the species of my pet.
Color:
*
Please provide me with detailed directions to feed your pet. Please be as detailed as possible. Use N/A where necessary.
Feeding Instructions
Location of where pet eats:
*
Does your pet eat dry food?
*
Yes
No
What time(s) of day is your pet fed their DRY FOOD. The times frames listed are during our designated pet care hours and may be adjusted according to your pet's visit schedule. Please check all that apply.
*
Not applicable
6:00am to 10:00am
12:00pm to 4:00pm
6:00pm to 9:00pm
8:00pm to 12:00am
Other
Name of dry food:
Location of where dry food is stored:
Amount to feed pet EACH feeding:
Item used to measure food:
Does your pet eat wet food?
*
Yes
No
What time(s) of day is your pet fed their WET FOOD. The times frames listed are during our designated pet care hours and may be adjusted according to your pet's visit schedule. Please check all that apply.
*
Not applicable
6:00am to 10:00am
12:00pm to 4:00pm
6:00pm to 9:00pm
8:00pm to 12:00am
Other
Brand of wet food:
Location where wet food is stored:
If this question does not apply to your pet please type N/A.
Amount of wet food to feed per feeding:
Location of extra dry food and/or wet food:
*
If this question does not apply to your pet please type N/A.
Location where food dishes are stored when not in use:
*
If this question does not apply to your pet please type N/A.
Location of extra food dishes:
*
If this question does not apply to your pet please type N/A.
Does the pet have a routine to follow before eating?
*
Yes
No
Please descibe the routine in detail below.
Does your pet require any of the following when eating? Check all that apply.
*
Not applicable
Feed apart from other pets
Supervise while eating
Remove food after a certain time
Dispose of uneaten food
Please specify how much time is needed before removing food
Please give detailed instructions on how to feed your pet.
*
Please specify the type of water you provide for your pet.
*
Tap
Filtered from refrigerator dispenser
Filtered from pitcher in refrigerator
Filtered from sink
Bottled
Location of water dish
*
Water dishes will be refilled daily for house sitting or at each drop in visit and cleaned 1x per day.
Is your pet restricted to a certain amount of water?
*
Yes
No
Please indicate how much water to provide at each refill
Special instructions for water
If this question does not apply to your pet please type N/A.
Does your pet receive treats?
*
Yes
No
Please indicate how many treats your pet can receive PER VISIT.
*
1/2 to 1 treat
1-2 treats
3-4 treats
No limit
Other
Location where treats are stored
*
If this question does not apply to your pet please type N/A.
When does your pet receive their treat?
Does your pet have a special routine to follow before getting a treat?
*
Does your pet require any of the following when receiving a treat?
*
Give treats apart from other pets
Supervise while eating treat
Remove treat after a certain time
Dispose of uneaten treat
Not applicable
Special instructions for treats
*
Does your pet receive medications? No need to include monthly preventative medications.
*
Yes
No
Medication #1
Location where Medication is stored
Medication times
Directions
Additional Information
If this question does not apply to your pet please type N/A.
If your pet has more than one medication please list the additional medications and instructions here.
Does your pet require a walk at our visit(s)?
*
Please walk my pet at all visits
Please walk my pet at least three times per day, otherwise please let my pet in the fenced yard.
Please walk my pet at least two times per day, otherwise please let my pet in the fenced yard.
Please walk my pet at least one time per day, otherwise please let my pet in the fenced yard.
Please only let my pet into the fenced yard. No walks are required.
My pet is NOT allowed outside. They use a litter box or potty pad
My pet is an outdoor pet. No walks are necessary.
Where do you keep your pet's leash and/or collar?
Please indicate if we need to avoid specific houses or areas while walking.
Please indicate your pet's walking route.
Location of pet waste bags
Does your cat or dog use a litter box or potty pads?
Yes
No
Location of litter box or potty pad
Location of extra litter or extra potty pads
How often do you scoop your litter box or change out the soiled potty pads?
*
Not applicable
Once every other day
Once per day
Twice per day
Three times per day
Four times per day
Every time the potty pad is soiled
Other
Where should I dispose of all pet waste?
*
Please let us know what games and or activities your pet likes to play and/or do.
*
Belly Rubs
Cuddle
Give kisses
Fetch
Tug-o-war
Chase
Walk
Run/Jog
Play with toys
My pet does NOT play games or activities
Other
Does your pet play with toys?
*
Yes
No
Location of toys:
Favorite Toys:
Please list the commands and words your pet knows, should know, or ones that you would like them to know.
*
My pet does not know any commands or words
Sit
Stay
No
Come or Come Here
Outside or Go Outside
Go Poop
Go Potty or Go Pee
Do your business
Bad or Bad Dog/Cat
Go in the House
Down or Get Down
Off
Walk or Let's go for a walk
Food
Treat
Are you hungry?
Do you want to eat?
Who is here?
Who is at the door?
Good or Good Dog/Cat
Move or Move over
Ride or Do you want to go for a ride?
Lay Down
Don't Pull of No Pull
Cookie
Drop It
Slow Down
Heel
Walk Nice
Naughty
Don't Touch
Leave it
Other
Is you pet crated or placed in a restricted area when no one is home?
*
Yes
No
Please let us know your pet's living situation below. Please note that I will not take pets outside off leash unless inside a secured fence.
*
NOT allowed outdoors at all
Kept outside in fenced yard ALL DAY
Kept outside in fenced ALL DAY & NIGHT
NOT allowed indoors at all
Allowed on furniture & beds
Allowed on counters & tables
Restrict to pet area/crate ALL DAY & ALL NIGHT
Restrict to pet area/crate NIGHT ONLY
My pet is not restricted and can have access to the entire house
Other
Location of crate, gated off area, or fenced in yard
Please type N/A if this question does not apply.
Please let us know which of the following does your pet NOT like.
*
Baths
Hot days
Sharing food dishes
People or other pets near food dish
People or other pets near treats
Nail trims
Rain
Cold
Loud noise
Vacuum
Thunder
Petting hind end
Petting near the head
New or Strange Animals
Humans
Touching Ears
Touching feet
Other family pets
Strangers
Fragrance sprays
None of the above
Other
Please let us know how your pet reacts to any of the above.
If this question does not apply to your pet please type N/A.
Please describe the incident(s) even if mild or under extreme or unusual circumstances
If this question does not apply to your pet please type N/A.
Where does your pet like to escape or hide?
*
Hides behind or under bed
Hides behind or under couch
Hides under tables
Hides in closets
Runs outdoors
Runs upstairs
Not applicable
Other
Please indicate how your pet can be retrieved if they hide or run away.
If this question does not apply to your pet please type N/A.
Does your pet have any ongoing or reoccurring known illnesses and/or injuries? Is your pet undergoing any medical treatments?
*
Yes
No
If yes please explain in detail.
Did your pet have a previous illness or injury we should be aware of?
*
Yes
No
If yes please explain in detail.
Has your pet been diagnosed with allergies?
*
Yes
No
If yes please list what type pf allergies below.
What type of symptoms does your pet exhibit when their allergies flare up?
Please let us know what temperament and personality describes your pet. Check all that apply.
*
Calm
Sweet
Loving
Cuddly
Aggressive
Hyper
Shy
Scared
Timid
Relaxed
Easy Going
Pushy
Suspicous
Aloof
Fearful
Lazy
Jealous
Trusting
Spiteful
Crazy
Other
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