Lend-a-Pet Information Form

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Health and Safety- It is imperative to us that we have the necessary info to give your pet the most enjoyable stay with the utmost care! **If you have multiple pets, please fill out a separate form for each! - YOUR PET WILL NOT BE PERMITTED TO STAY WITH US UNTIL THIS FORM IS SUBMITTED. THANK YOU!**

Email *

Please Enter Today's Date *

YYYY

Owner's First Name *

Owner's Last Name

Address *

Phone Number *

Emergency Contact *

What services are you interested in? *

Daycare

Overnight Stay

Drop-in Visit

Required

Pet's Name *

Date of Birth *

YYYY

Breed/Color *

Sex *

Male

Female

Neutered/Spayed *

Yes

Vet Name *

Vet Phone Number *

For safety, we ask you to provide a copy of your pet's vaccination records. How will you provide it? *

I will print out a copy to provide during drop off

Before drop off, I will email a copy to: lendapetassociation@gmail.com

How long have you had your pet? *

From where did you obtain your pet? *

Is your pet crate trained? *

Yes

Is your pet house trained (potty trained)? *

Yes

Does your pet have a microchip? (If so, please provide below) *

Date of last Vet check up? *

YYYY

Is your pet up to date on all vaccinations? *

Yes

Is your pet on flea/tick preventative? *

Yes

Is your pet on heartworm pill? *

Yes

Does your pet have any known allergies, medical problems, or restrictions? If so, please explain.

What times does your pet get fed? *

How much does your pet eat per meal? *

Any specific treats your pet likes?

Any special feeding instructions (foods to avoid)?

Please explain sleep routine (crate, bed etc. You are welcome to bring whatever will make your pet comfortable). *

Does your dog exhibit any of these behaviors? Check all that apply

Barking excessively

Dominance

Leash pulling on walks

Marking inside

Separation anxiety

Does your pet guard objects or food? *

My pet is object aggressive

My pet is food aggressive

My pet is both object and food aggressive

No, my pet is NOT object or food aggressive

Does your pet get along with other dogs? *

Yes

Has your dog ever snapped at another dog? Please explain. *

Has your dog ever bitten or gotten into a fight with another dog? Please explain. *

Is your pet afraid of fireworks or thunderstorms? *

Yes

Has your pet ever jumped or climbed a fence? If so, what height fence? *

Does your dog mount other dogs? *

Yes

Maybe

Does your pet get along with cats? *

Yes

Not sure

Has your dog been to training or obedience classes? *

Yes

Please list any other behavioral problems I should know about. (For example, doesn't like small dogs, jumps on counter, gets into garbage etc.)

Were you referred to us by someone? If so, by who?

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