Creature Comforts: Owner, Pet and Vet Information

Name ( Human )*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Emergency Contact ( other than owner )

First NameLast Name

Emergency contact phone #

Please enter a valid phone number.

Authorized to pick up your pet(s)

First NameLast Name

Pet Name*

Name

Pet Breed (list size if unknown)*

Breed (lbs.)

Sex*

Age (or date of birth )*

Estimated Date of Birth

MonthDayYear

Spayed/Neutered*

Has your pet ever bitten, or shown aggression toward a person or another animal?*

YesNo

Is your pet nervous around people, other animals or loud noises, like thunderstorms or fireworks?

Scared of StormsScared of FireworksOtherNot bothered by much

Does your pet have any pre-existing health conditions, such as arthritis or diabetes?

Brand of Food your pet eats*

Amount of food per day (cups)*

cups

Who is your pet's current Veterinarian?*

Clinic/ DVM

How did you hear about Creature Comforts?

friend/google/facebook

May we use pictures of your pet on social media?*

YESNO

Boarding & Daycare Agreement