Client Information Form

Email Address: *With your email, you will be enrolled in our Pet Portal program, a great way to keep up-to-date records of your pet. Ask an employee at the front desk for details.

Co-Owner Name:

Co-Owner Phone Number:

What is the best phone number to reach you?

How did you hear about us?

Friend

Newspaper Ad

Website/Internet Search

Facebook

Sign

Other

If you were referred by a client, what is their name?

What is your pet's current diet/food?

Visit dog parks?

yes

no

Board or go to Daycare?

yes

no

Go for a daily walk?

yes

no

Go to the groomer?

yes

no

Go in wooded or high grass areas?

yes

no

If your pet is a cat, are they

indoor

outdoor

Are there any new medical conditions or medications your pet has started since your last visit with us?

yes

no

If yes, please list:

Do you give any over-the-counter medications?

yes

no

If yes, please list:

Is your pet currently on heartworm prevention?

yes

no

If yes, what kind?

Is your pet currently on flea and/or tick prevention?

yes

no

If yes, what kind?

While your pet is here, would you like any of the following services to be performed?

Nail trim

Express anal glands

ID Microchip

Flea/tick prevention application

We also offer the following, please select if you would like to learn more.

Bathing

Boarding

Behavior Consultation/Training Class

Dog Park

Daycare/Playgroups

Client Information Form

Email Address: *With your email, you will be enrolled in our Pet Portal program, a great way to keep up-to-date records of your pet. Ask an employee at the front desk for details.

Co-Owner Name:

Co-Owner Phone Number:

What is the best phone number to reach you?

How did you hear about us?

If you were referred by a client, what is their name?

Pet Information Update

What is your pet's current diet/food?

Does your pet:

Visit dog parks?

Board or go to Daycare?

Go for a daily walk?

Go to the groomer?

Go in wooded or high grass areas?

If your pet is a cat, are they

Are there any new medical conditions or medications your pet has started since your last visit with us?

If yes, please list:

Do you give any over-the-counter medications?

If yes, please list:

Is your pet currently on heartworm prevention?

If yes, what kind?

Is your pet currently on flea and/or tick prevention?

If yes, what kind?

While your pet is here, would you like any of the following services to be performed?

We also offer the following, please select if you would like to learn more.

Monday:	8:00am – 10:00am 4:00pm - 6:00pm
Tuesday:	8:00 am–10:00 am 4:00 pm-6:00 pm
Wednesday:	8:00 am–10:00 am 4:00 pm-6:00 pm
Thursday:	8:00 am–10:00 am 4:00 pm-6:00 pm
Friday:<	8:00 am–10:00 am 4:00 pm-6:00 pm
Saturday:	9:00am–11:00am
Sunday:	4:00 pm–6:00 pm