Tell Us About Your Pet!
Please fill out this form to allow Copeland's to get to know you and your pet(s).
In order to hold a reservation at Copeland's we must obtain an emergency credit card number (over phone call).
CUSTOMER INFORMATION:
Owner's Name *
Your answer
Phone Number *
Your answer
Address *
Your answer
Email
Your answer
Emergency Contact (name and number) *
Your answer
PET INFORMATION:
Pet Species *
Pet Name *
Your answer
Breed *
Your answer
Color *
Your answer
Age *
Your answer
Sex *
Weight *
Your answer
Vet (pet must be updated on vaccines) *
Your answer
Describe Your Pet *
Tell us about your baby's favorite activities and personality!
Your answer
Any special requirements:
Your answer
Any Additional Pets: (please state the same information above)
Your answer
How did you hear about us?? *
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