Name: _______________________________________________________________________________

Street Address: __________________________________________________________________________

Mailing Address:  ______________________________________________City: ______________________

State: ___ Zip Code: ______________ Phone: (H) _____________________________ (W)____________

E-Mail:  _______________________________________________________________________________

Pet’s call name __________________________________________________________________________

Breed _________________________________________________   Weight if known  ________________

Boarding Dates Reserved:___________________________________________________________________

Drop off/Pick up own pet: Yes ___   No____     or we pick up/drop off  Yes ___   No____ If so, Cost: _______

Is your pet used to dog crates?    Yes ___   No____

Circle Crate Size:     Cat/Extra Small    |    Toy/Small     |     Medium    |      Large   |      Extra Large       |

Boarding Rate:______________ Multiple Pet Discount: Yes ___   No____ Discount Coupons: Yes ___   No____

First Time Client:   Yes ___   No_____     Referred by: __________________________________________

Repeat Client:     Yes ___   No_____

Spayed or neutered? Yes ___   No____

Regular Food Supplied:    Yes ___   No___   Our Food:  Yes ___   No___  No. of times fed a day  ____

Any significant health issue?  Yes ___   No____  If yes, Explain _________________________________________

_______________________________________________________________________________________________

Medications need to be dispensed? Yes ___   No____If yes, Explain ____________________________________

_______________________________________________________________________________________________

Has your pet  taken obedience or puppy kindergarten classes? ________________________________

Would you like information on our training while boarding? Yes ___   No____

Do you have a current veterinarian?     

Name/Business Name:  __________________________________________________________

Address: _______________________________________________________________________ 

City: __________________________________ State: ____   Phone:_________________________

Please list at least one backup contact, if you can’t be reached.

Name: ______________________________________________________________________________

Address: ____________________________________________________________________________

City/State  ________________________________     Phone:  __________________________________

E-mail: ________________________________________________________________

Add information below that you feel we should know about your pet to assist in his/her care. Thank you filing out this form.