Pet Intake Form Pet Owner's Name(Required) First Last Phone Number(Required)Email(Required) Pet(s) Name(Required) Breed(Required) Age(Required) Size(Required) 1-20 lbs. 21-45 lbs. 46-100 lbs. >101 lbs. Sex(Required) Male Female Status(Required) Spayed Neutered Intact Coat Color(Required) Has your pet been boarded before?(Required) No Yes With us? No Yes What is your pet's personality? (Assertive/Outgoing/Timid/Fearful/Aloof)(Required) Pertinent Health History – Past & Present (medical problems, recent surgeries, & physical limitations)(Required)Does your pet have any allergies, especially to food? If so, please explain.(Required) Are there any specific types of people, dogs, animals, or situations your pet dislikes? If so, please explain.(Required) Is there any additional information not covered in this form that we need to know about your pet?Canine Only: Please check all that apply to your dog. Excessive barking Strong prey drive Jumps on people Escape artist (dig under or jump fences) Pee when excited or when submissive Likes baths House broken Swallows stuffing of toys Guards (food, toys, bones, bed, etc.) Anxious of strangers Destructive behavior Separation anxiety Fears or reactive to other dogs Bowel/bladder control problems Nips/bites if afraid Does your dog have aggressive guarding tendencies? (food, toys, beds, etc.) No Yes How does your dog act when playing? (Vocal/Rough/Aloof/Nippy/Bully) Has your dog ever been in a fight with or been bitten by another dog? No Yes If yes, what were the circumstances? Has your dog ever bitten a person? No Yes If yes, what were the circumstances? Are there any other conditions/quirks you feel we should be aware of? Feline Only: Please check all that apply to your cat. Declawed Litter box trained Uses bathroom outside of box On hairball medication Play with toys Does not like strangers Will bite if afraid or challenged Likes to be brushed Likes to be picked up or held Likes other cats What is your cat's activity level? (Low/Moderate/High) What is your cat's personality? (Cuddly/Playful/Timid/Aloof/Spicy) How many times per day to feed (additional charge if more than twice):(Required) 1 2 3 Other Breakfast Kibble Wet Other Lunch Kibble Wet Other Dinner Kibble Wet Other If your pet is not eating, is it okay to add things to their food such as wet food, topper, etc. to entice them to eat?(Required) No Yes, wet dog food Yes, wet cat food Yes, dehydrated topper Yes, peanut butter Yes, chicken Yes, add water If your pet gets diarrhea due to stress, is it ok to add chicken and rice, rice only, dehydrated topper, etc. to their food?(Required) No Yes, chicken and rice Yes, rice only Yes, dehydrated topper Other If there is something that you use for this, please bring it and give instructions.Is your pet on any medications that we need to administer?(Required) No Yes If yes, what medications and when to administer?Please bring instructions for medication administering.
