Canine Boarding Client Info Form

Pet's Name*

Owner's Name*

Co-owner / Significant Other

Owner's Email Address*

Preferred Phone Number*

Cell
Home
Office

Additional Phone 1

Additional Phone 2

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How did you hear about us?

PET INFORMATION

Pet's Breed*

Pet's Weight*

Pet's Birthdate*

Gender*

Male
Female

Spayed or Neutered*

Spayed
Neutered
Neither/unknown

EMERGENCY CONTACT INFORMATION

1st Contact Name*

1st Contact Phone

1st Contact Alt. Phone

2nd Contact Name

2nd Contact Phone

2nd Contact Alt.Phone

PET HISTORY

Regular Veterinarian Name and Practice:

Allergies:

Phobias (loud noises, lightning, men, etc.)

Socialization issues (aggression, fear of people/dogs):

Pet motivated by (food, toys, etc.)

Does your pet have any major medical issues (past and/or present)?

ACTIVITY/EXERCISE

What type and quantity of exercise is normal for your pet on a daily/weekly basis?

Is your pet walked using:

Head harness
Body harness
Collar
Fixed lead
Flexi-lead
Other

FEEDING/MEDICATIONS/SUPPLEMENTS

First Brand of Food Given*

First brand of food type (wet, dry, other):

Quantity of first food*

First food, when fed (AM, PM, Other)

Second brand of food given:

Second brand of food type (wet, dry, other):

Quantity of second food:

Second food, when fed (AM, PM, other):

What snacks/treats are given?

Quantity of snacks and when given:

Supplements given (type, amount and when given):

Medications given (type, amount, when given):

Flea / Tick / Heartworm Prevention (type, amount, when given):*

BATHROOM HABITS

How often does your pet defecate?

Any stool issues (soft, hard, loose)?

Any commands/phrase to help them go to the bathroom?

Any problems going to the bathroom while on a leash?

How often does your pet urinate?

ADDITIONAL SERVICE REQUESTS

Services:

Extra activity sessions
Play groups
Trail walks
Pasture play
Nail trim
Gelato

*Note: Charges may apply for additional services.

Please give us any other information that you feel could be beneficial to us in helping your pet:

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