Owner/Client_________________________________ Pet___________________________
Emergency Care: (Prearrange Treatment Billing with Veterinary office Before Leaving is Recommended)
Vet. Name:_______________________________Pet Allergies:________________________________
Clinic Name:______________________________Vaccinations up to date: Y / N
Phone:___________________________________Heartworm test: Negative / Positive
Pet Medical History: (On going or reoccurring known illnesses / injuries / treatments & medications)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Temperament / Personality
Pet Doesn't Like:
___ Baths ___ Hot Days ___ Sharing Food Dishes
___ Toenails Clip ___ Rain/Snow/Cold ___ Loud Noise/Vacuum/Thunder
___ Massage ___ New Animals ___ All People
___ Touch Ears ___ Other Family Pets ___ Strangers
___ People near food dish ___ ___
Pet reacts to the above by: __________________________________________________________
Has Pet Ever: Describe (even if mild or unusual situations)
___ Attacked someone / bit someone
___ Attacked another animal
___ Injured self
___ Escaped house / yard
Where does pet like to escape to ?
How can pet be retrieved ?
Concerns:
Pets Favorite Games, Toys, and Activities: ______________________________________________
My "Pet Pals" home pet sitters must be advised of any other person who has access to your home.
___________________________________________________________________________________
Comments:
How may we reach you while you are away? Hotel: ________________________
Cell phone: __________________________ City: ____________________State:______
Email: ______________________________ Phone: ____________________________
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