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Client name(s): ___________________________

Client's Cell phone and home phone and email address:_______________________________________

Client's address (please indicate if assigned parking space number): __________________________


Pet's name:________________________Age: ____________ Birthday:____________________

Breed:_________________________ Color/Markings:______________________

Sex: Male / Female Neutered or Spayed: YES / NO Micro chipped: YES / NO

Rabies tag #:________________ Date rabies shot expires: ___________________

Known health problems: __________________________________________________________________________

Vet information:__________________________________________________________________________

Feeding:Please detail your pet’s feeding routine, including type, location, and amount of food, approximate feeding times, special instructions, etc.




Medication:If your pet is on any medication that must be administered, please provide detailed instructions, including medication name, location, dosage, and frequency and use the back of this form if more space is needed.





Does your dog or cat have a favorite game?___________________________________

Where do you keep your collar and leash? ______________________________________

Does your dog need a special harness or choke collar for walks? _________________________

Does your dog or cat have favorite hiding places? _____________________________________

Traits: Please answer the following brief questionnaire about your dog or cat. It will help me to better care for him/her:

Is friendly with other dogs or cats YES / NO                    Likes new adults YES / NO Likes children YES / NO

Is fearful of noises or other things YES / NO                   Obeys basic commands YES / NO

Must stay on leash during walks YES / NO                       Is allowed to have treats YES / NO

Is allowed in the house YES / NO                                    Is allowed outside the house YES / NO

Is prone to digging YES / NO                                           Is prone to chewing YES / NO