Pet Profile Which pet do you have? * Cat Dog OWNER INFORMATION Owner Name * Phone * Owner Name Phone Mailing Address * City * State * Zip Code * Email * GUEST INFORMATION Pet's Picture (1 MB) SMALL! Drop a file here or click to upload Choose File Maximum upload size: 3MB Please upload an image of your pet and make sure the picture is SMALL! Pet's Name * Pet's Birthday Pet's Age * Pet's Color * Pet's Breed * Pet's Weight * Pet's Sex * M F Is your pet Spayed/Neutered? * No. Spayed Neutered Summit County License VETERINARIAN INFORMATION Veterinarian Name * Veterinarian Address Phone * Fax Authorized Veterinary Urgent Care Spending Limit $ EMERGENCY CONTACT Local emergency contact * Phone * Authorized Release Contact * Authorized Contact's Phone FEEDING Times per day * AM MID-DAY PM Type of Food * Qty per feeding * If the pet is not eating or has diarrhea, we add low residue food MEDICAL Does your Pet take any medications? * Yes No If yes, please list the medications or care requirements. Is your pet allergic to any medications and/or food? * Yes No If yes, please list the medications and/or food Does your pet have any injuries or chronic health problems? * Yes No If yes, please list the injuries and explain BEHAVIOR How would you describe your pet activity level * Low Average High Has your pet ever bitten a person? * Yes No If yes, please explain Has your pet ever bitten another dog or acted unfriendly towards another dog? * Yes No If yes, please explain Have you boarded your pet before? * Yes No If yes, was the experience positive? Is your pet house trained? * Yes No Does your pet have a tendency to chew things (beds, toys, etc.) * Yes No Have you participated in any type of formal obedience training with your Pet? * Yes No If yes, please explain Does your pet try to escape enclosures or jump fences? * Yes No List any other special care or boarding requirements to be provided by Doginhaus: CAT SPECIFIC QUESTIONS Check all answers that describe your cat’s personality? * Outgoing Verbally Sensitive Timid Affectionate Pushy Independent Reserved Confident Submissive Clingy Excitable Playful Gentle Mouthy Is your cat litter boxed trained? * Yes No Is your cat declawed? * Yes No How would you describe your cat’s demeanor while riding in a car? * Enjoys Dislikes Neutral List any other special care or boarding requirements to be provided by Doginhaus: OWNER SIGNATURE * PRINTED NAME Date If you are human, leave this field blank.
