New Client Information

Pet Information Form:

Thank you for joining our pack. Please fill out this form to help us best care for your pet!
Pet's Name(s)*
Human's Full Name*

First NameLast Name
Human's Email*
example@example.com
Your Phone Number *
Please enter a valid phone number.
Social Media:

If you have an instagram and want us to tag you in camp stories, please share your account name(s).
Human Account Name(s):
You Can List Multiple, please just add a comma between each.
Your Pet's Instagram:
We will tag you in photos
Significant Other/ Additional Contact Name

First NameLast Name
Significant Other/Additional Contact Phone Number
Please enter a valid phone number.
Significant Other/Additional Contact Email
example@example.com
Do You Want Your Additional Contact Person on Calendar Invites?

YesNo

Emergency Contact Information
The emergency contact must be someone other than yourself and spouse/partner or friends that are traveling with you.

We will always try to contact you first but need another option if you are traveling or out of the country.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Vet Clinic & Dogtor's Name*
Veterinarian Phone*
Clinic Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Tell Us About Your Pet:
Eating Habits*
How many times a day, how much per meal, remind us if they food/treat guard
My pet(s) take medications, here are the details:
Reminder: We require the prescription bottle to be brought with your pet(s). Please be sure to pack whatever carrier they need for their meds (cheese, pill pockets, peanut butter, etc.)
Indoor Behaviors::*

Crated When Home AloneCrated OvernightFree RoamRetaliation Potties When Left AloneMarks (this is a urinating indoors or outdoors behavior)
Anything special we should know?*
Bathroom Habits, Commands, Behavior Tics, Allergies, Fears, etc.

Proof of Vaccinations
Please submit proof of up-to-date vaccinations here.

Camp Rockford requires the following to board with us in our home:

Sterilization, Rabies, Bordetella, Distemper, Hepatitis, Parainfluenza, Parvovirus, and Leptospirosis (which is often combined by veterinarians as DHLPP or DHPP).

Additionally, we require proof of negative fecal exam results.

Must show date of next due vaccinations.

***You can submit multiple documents via each file upload field.
Proof of Vaccinations:

Must show date of next due vaccinations. You can submit multiple documents via this upload.
Cancelof
Proof of Negative Fecal Exam Results

Annual Results are fine if within the last 12 consecutive months.
Cancelof
Is your pet on flea & tick medication? Please note: Should a dog be observed to have fleas or ticks, a flea/tick bath treatment will be applied and charged to the owner at a rate of up to $80.00 depending on severity and size of dog.*

YesNoOnly during Summer/Fall
Should be Empty:

Pet Information Form: