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Pet Information
As professional pet care specialists, we form bonds with your pets as we spend time with them. Getting as much information about them right from the start will help us figure out the best way to begin building that relationship. Please fill out a new form for each pet. Thank you!
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* Required
Owner Name
*
Your answer
Pet Name (please fill out a new form for each pet)
*
Your answer
Species
*
Your answer
Breed
*
Your answer
Color
*
Your answer
Age
*
Your answer
Birthdate (If unknown, approximate age or adoption date)
Your answer
How long have you owned this pet?
*
Your answer
Sex
*
Male
Female
Is this pet spayed or neutered?
*
Yes
No
Not old enough at this time
Not applicable for this pet
Primary Veterinarian
*
Choose
Westerly Animal Hospital
VCA Turco Animal Hospital
Atlantic Animal Hospital & Wellness Center
Charlestown Animal Hospital
Four Paws Veterinary Services
Ocean State Veterinary Specialists
Pawcatuck Veterinary Clinic
Salt Ponds Animal Hospital
Stonington Veterinary Hospital
Other - please write below
Other Veterinarian NOT Stated Above (please include phone number and address)
Your answer
Secondary or Emergency Veterinarian
Choose
Westerly Animal Hospital
VCA Turco Animal Hospital
Atlantic Animal Hospital & Wellness Center
Charlestown Animal Hospital
Four Paws Veterinary Services
Ocean State Veterinary Specialists
Pawcatuck Veterinary Clinic
Salt Ponds Animal Hospital
Stonington Animal Hospital
Other
Other Veterinarian NOT Stated Above
Your answer
Is this pet up to date on vaccinations? Proof of vaccinations required prior to first visit.
*
Yes
No
Is this pet on flea/tick preventatives?
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Yes
No
If yes, please describe
Your answer
Is this pet on heartworm medication?
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Yes
No
If yes, please explain
Your answer
Is this pet microchipped?
*
Yes
No
N/A
If yes, which company and what is their microchip #?
Your answer
Does this pet have insurance?
*
Yes
No
What company are they insured through?
Your answer
Can this pet have treats?
*
Yes
No
Does this pet have any allergies?
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Yes
No
If yes above, please explain
Your answer
Feeding instructions (amount, location of food, location of bowl, etc.)
Your answer
Does this pet take medication(s)?
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Yes
No
If yes above, what medications? Doses? Times?
Your answer
Where do you keep this pet's leash, collar, harness, waste bags, etc.?
*
Your answer
Is there anything we need to know about your neighborhood? (Dogs/areas to avoid, dogs/areas to not avoid, etc.)
*
Your answer
Does this pet use a litter box or potty pad?
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Yes
No
Where are litter box or potty pads located?
Your answer
Where are extra litter/potty pads kept?
Your answer
Where should pet waste be disposed?
*
Your answer
Is this pet crated or kept in a restricted area when home alone?
*
Yes
No
If yes above, please explain
Your answer
Has this pet ever done any of the following?
*
Attacked and/or bit a person?
Attacked and/or bit another animal?
Escaped from home?
Injured self out of boredom/fear?
N/A
If yes to any of the above, please describe the incident(s), even if mild or under extreme or unusual circumstances?
Your answer
Does this pet like to hide or escape?
*
Hides behind or under couch
Hides behind or under bed
Hides under tables
Hides in closets
Runs out doors
Runs upstairs
N/A
If this pet has escaped from home, did they return on their own?
Yes
No
Clear selection
Does this pet have any ongoing or reoccurring known illnesses and/or injuries? Is this pet undergoing any medical treatments?
*
Yes
No
If yes above, please explain
Your answer
Did this pet have any previous illness or injury we should be aware of?
*
Yes
No
If yes, please explain
Your answer
Does this pet have any training (formal or informal)?
*
Yes
No
If yes above, please explain (include known commands, completed classes, trainers, etc.)
Your answer
If a dog, does s/he have recall?
*
Yes
No
Sometimes, not 100%
N/A
What is this pet's personality and general behavior?
*
Your answer
Is this pet allowed on furniture? Any furniture they're not allowed on?
*
Your answer
If adopted, is anything known about this pet's history?
Your answer
What is this pet's daily routine?
*
Your answer
What services are you looking for? Choose any that apply.
*
Solo Dog Walking
Group Walks
Pack Hikes
Drop Ins
Overnights
Farm Sitting
Nail Trims
Required
If this pet is a dog, would you like them to be socialized with other dogs, including staff members' personal dogs? (ex. walking with other client dogs)
*
Yes
No
N/A
Any other information that has not been covered that you feel we should be aware of?
Your answer
Do you authorize the use of this pet's photos and/or videos on our social media pages, website and/or marketing materials for promotional purposes?
*
Yes
No
We try our best to schedule the same walker every week but understand things happen. In the event that your usual walker/sitter is unavailable, would you like us to assign a replacement walker?
*
Yes, assign someone else for the visit(s)
No, cancel visit(s) until usual walker is available
Date
MM
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/
YYYY
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