NY Paw Pals - Client Info Form

Client & Pet Information Form

First Name*

Last Name*

Address*

City*

State*

Zip*

Home phone*

Work phone*

Cell phone

Email*

Phone during business hours

Secondary Pet Owner / Authorized Guardian

First Name 2 (secondary pet owner)

Last Name 2

Address 2

City 2

State 2

Zip 2

Home phone 2

Work phone 2

Cell phone 2

Email 2

Emergency Contact - Name 2

Emergency Contact - Phone

General Pet Information

General Pet-Information

More than one pet? Please complete the information for each pet in your household!

It is important that you provide all of the information below so that we have the correct contact information on file. If any of the information below changes, please contact our office so we may update your records.

Name of Pet*

Type (e.g. cat, dog)*

Breed

Description

Birthday/Age

Sex M / F

Spay/Neuter Y / N

Estimated Weight

Allergies

Feeding Instructions - Morning Quantity*

Feeding Instructions - Midday Quantity*

Feeding Instructions - Evening Quantity*

Medication Instructions Morning /Quantity*

Medication Instructions Midday Quantity*

Medication Instructions Evening Quantity*

Health Issues (Past or Current)?*

Pet Behavior Information

It is important that you provide all of the information below, so that we have the correct information on file. If any of the information below changes, please contact our office, so we may update your records.

Has your pet ever bitten a person or another animal? Y / N*

Please describe your petʼs behavior towards new people*

Has your dog had any formal training? If so, what type?*

Does your pet know any cues that you would like us to use out on walks?

Please describe your petʼs behavior around food and water dishes, toys and bones.

How would you describe your dogʼs personality?*

General Pet-Information

More than one pet? Please complete the information for each pet in your household!

It is important that you provide all of the information below so that we have the correct contact information on file. If any of the information below changes, please contact our office so we may update your records.

Thank You for filling out our Customer & Pet information form!