New Client Application
Please fill out one form per dog. Please read over T&C If you have any issues with the form please email us at houndsretreat25@gmail.com
Client Name
*
Email
*
example@example.com
Phone Number
*
Address
*
Emergency Contact Name
*
Phone Number
*
Your Dogs Details
Pet Name
*
Breed
*
Age
*
Sex
*
Vet Practice Name & Address
*
Is your dog Spayed/Neutered
*
Yes
No
Date of last season ( For the safety and comfort of all dogs, females in season cannot attend until their cycle is over.)
Date of Last Vaccination (booster) (Please bring your pets up to date vaccination record with you on arrival )
*
Date of next Vaccination (booster) (Please bring your pets up to date vaccination record with you on arrival )
*
Date of last Kennel Cough (Bordetella) Vaccination. please note there is a 14 day waiting period after receiving the kennel cough vaccination)
*
Is your dog on regular parasite treatment (Flea, Wormer, Tick)
*
Yes
No
Is your dog on any medications or have any Allergies .( please note we cannot administer injections.)
Please note any other information regarding your dog (Likes, Dislikes, Behaviour)
*
How did you hear about us?
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