Tappy Toes Co. Intake Form

Tappy Toes Co

Pet Intake Form
Client Name*

First NameLast Name
Pet Name:*
Breed:*
Pet Name:*
Breed:*
Species*

CanineFelineAvian (bird)Amphibian (Frog)HorseGoatChickenRabbitI am not sureHamsterOther
Approximate Date of birth*

MonthDayYear
Approximate Date of birth*

MonthDayYear
Sex:*

MaleFemale
Sex:*

MaleFemale
Spayed or Neutered:*

Yes, my pet(s) are spayed/neuteredNoNo - my pet is too young at the time of completetionNot applicable due to the species of my pet.
Color:*
Color:*
Please provide us with detailed directions to care for your pet. Please be as detailed as possible.
Feeding Instructions
Location of where pets eats: *
Does your pet eat dry food?*

YesNoOther
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 applicable6:00am to 10:00am12:00pm to 4:00pm6:00pm to 9:00pm8:00pm to 12:00amOther
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?*

YesNoOther
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 applicable6:00am to 10:00am12:00pm to 4:00pm6:00pm to 9:00pm8:00pm to 12:00amOther
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?*

YesNo
Please descibe the routine in detail below.*
Does your pet require any of the following when eating? Check all that apply.*

Not Applicablefeed apart from other petsSupervise while eatingRemove food after so much timeDispose of uneaten food
Please specify how much time is needed before removing food*
Please give detailed instructions on how to feed your pet.*
Please speficy the type of water your provide for your pet.*

TapFiltered from refridgerator dispenserFiltered from pitcher in refridgeratorFiltered from sinkBottled
Location of water dish*
Water dishes will be refilled at each visit and cleaned 1x per day.
Is you pet restricted to a certain amount of water? *

YesNo
Please inidicate 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?*

YesNo
Please indicate how many treats your pet can recieve PER VISIT.*

1/2 to 1 treat1-2 treats3-4 treatsNo limitOther
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 petsSupervise while eating treatRemove treat after so much timeDispose of uneaten treatNot Applicable
Special instructions for treats*
Does your pet receive medications? No need to include monthly preventative medications.*

YesNo
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 medications please list the additional medications and instructions here.*
Does your pet require a walk at our visit(s)?*

Please walk my pet at all visitsPlease 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 padMy pet is an outdoor pet. No walks are necessary, just play and feed/water.
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 use a litter box or dog use potty pads?

YesNo
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 ApplicableOnce every other dayOnce per dayTwice per dayThree times per dayFour times per dayEverytime the potty pad is soiledOther
Is this paperwork for a bird or small caged pet? If so please let us know how often we need to clean their cage and the directions to do so. Light cleaning is included in visit cost. *
Is this paperwork for a farm animal? If so please let us know how often we need to clean their stall and the directions to do so. Light cleaning is included in visit cost. *
Where should we dispose of all pet waste?*
Please let us know what games and or activities your pet likes to play and/or do.*

Belly RubsCuddleGive kissesFetchTug-o-warChaseWalkRun/JogPlay with toysMy pet does NOT play games or activitiesOther
Does your pet play with toys?*

YesNoSometimesOnly with X person and Y toy; probably not you.
Location of toys:
Favorite Toys:
Is you pet crated or placed in a restricted area when no one is home?*

YesNo
Please let us know your pet's living situation below. Please note that Fuzzy Friends will not take pets outside off leash unless inside a secured fence.*

NOT allowed outdoors at allKept Outside in fenced yard ALL DAYKept Outside in fenced yard ALL DAYKept Outside in fenced ALL DAY & NIGHTNOT allowed indoors at allAllowed on furniture & bedsAllowed on counters & tablesRestrict pet area/crate ALL DAY & ALL NIGHTRestrict pet area/crate NIGHT ONLYMy pet is not restcited and can have access to the entire houseOther
Location of crate, gated off area, or fenced in yard*
Please type N/A if this question does not apply.
Desired area of exercise *
Please type N/A if this question does not apply.
Please let us know which of the following does your pet NOT like.*

BathsHot DaysSharing Food DishesPeople or other pets near food dishPeople or other pets near treatsNail trimsRainColdLoud NoiseVacuumThunderPetting Hind EndPetting near the headNew or Strange AnimalsHumansTouching EarsTouching FeetOther family petsStrangersFragrance SpraysNone of the aboveOther
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.
Has your pet ever done any of the following?*

Attacked and/or bit someoneAttacked and/or bit another animalEscaped from homeInjured self out of boredom/fearNot Applicable
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 bedHides behind or under couchHides under tablesHides in closetsRuns out doorsRuns upstairsNot ApplicableOther
Please indicate how your pet can retrieved.*
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?*

YesNo
If yes please explain in detail.
Did your pet have a previous illness or injury we should be aware of?*

YesNoUnknown
If yes please explain in detail.*
Has your pet been diagnosed with allergies?*

YesNo
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.*

CalmSweetLovingCuddlyAgressiveHyperShyScaredTimidRelaxedEasy GoingPushySuspicousAloofFearfulLazyJealousTrustingSpitefulCrazyOther
This form was prepared by:*

First NameLast Name
Date*

MonthDayYear
Date
Please use your mouse or finger to sign this document electronically.
Signature of person preparing form:*

Powered by Jotform SignClear
Services and Terms
Should be Empty:

Tappy Toes Co

Please provide us with detailed directions to care for your pet. Please be as detailed as possible.

Feeding Instructions