Pet Information Sheet

* Owner's Name

(Please fill out an individual sheet for each of pet)

* Pet Name

* Species Cat
Dog

* Gender Male
Female

* Condition Neutered
Spayed
Neither

* Age or Date of Birth

* Breed

* Weight

* Brief description of color and markings

Please fax current health certificate (shot records) to 1-888-607-8214.

Please answer Yes or No to the following questions. If the answer is yes, please provide details.

* Does your pet require a special diet?

* Does your pet require medication?

* Does your pet have any medical conditions such as seizures, allergies, injuries, growths, prone to hot spots?

* Does your pet require any special handling?

* Is your pet afraid of other dogs, cats, or humans?

* Is your pet aggressive toward other cats, dogs, or humans?

* Has your dog ever bitten anyone?

* Is your pet afraid of storms?

* Is your pet a known digger or climber?

* Please provide a brief description of your normal feeding schedule for your pet.

* Please provide the usual times during the day your pet has the availability to relieve themselves.

* Please provide any other information you feel would help us give your pet the proper care and attention during their stay with us?

* Verify