Adobe FormsCentral

PET INFORMATION

You will need to fill out this form for EACH pet.

Client Name: *

E-mail *

Pet Name: *

Species: *

Breed: *

Color/Markings:

Age: *

Weight: *

DOB / Gotcha Date: *

Sex: *

Male Female

Neutered/Spayed: *

Yes No

Are all vaccinations current? *

Yes No

Date of Last Vaccinations: *

If no, please specify why:

Microchipped?

Yes No

Is your pet sensitive to heat

Is pet aggressive?

Yes No

Please specify:

Has your pet bitten anyone (person or animal)?: *

Yes No

Please explain incident(s):

FEEDING

How many times a day fed?:

At what time(s)?:

Describe meal #1

Describe meal #2:

Describe meal #3:

Describe meal #4:

Is their water?:

Tap Filtered

Are treats ok?:

Yes No

What is allowed and quantity?

Comments:

MEDICATIONS

Does your pet receive medications(s)? *

Yes No

List each medication, how many times per day it is given, and the dosage amount (please be very specific):

BEHAVIOR

Are there any recurring illness/injuries or allergies? Please describe: *

Has your pet escaped the house or yard?:

Yes No

What works to retrieve them?:

Are there any triggers that cause a reaction in your pet, such as other animals, ears touched, squirrels, men, etc.?:

What commands should we use in that scenario?:

WALKS

How is your dog walked?:

Leash Gentle Leader Special Collar Harness Backyard only

Will they go out in rain or bad weather?

Yes No

Are they heat-sensitive?:

Yes No

How would you like us to alter the visit to account for rain, bad weather, heat, etc?:

How are their walk manners?:

Is there a preferred route or any favorite places/potty areas?:

Are there walk routines/key phrases we need to use?:

Any areas/homes/animals we need to avoid?

Are strangers an issue?

Is jumping, biting or chewing an issue?:

Yes No

How should we correct them?

Where should we dispose poopy bags?:

LITTER

How often should the litter be scooped?

How often should the entire litter be changed and/or add fresh litter?

Where do we dispose of all poopies?

GENERAL

What commands do you use that we need to use?:

What indoor play activities do they enjoy?:

Which are their favorite toys?:

Any additional information we should know?