Daycare Application (required prior to making a daycare reservation)

PET DAYCARE APPLICATION

In order for your pet to attend Daycare at The Pet Set, you must complete an application form. A separate form must be submitted for each pet.

Once you have submitted the Application form, you may make an appointment for Temperement Testing and Daycare. Temperement Testing can be done before or on the first day of care.

PRIMARY PET OWNER'S INFORMATION

First Name: *

Last Name: *

Email Address: *

Home Telephone: *

XXX-XXX-XXXX

Cell Telephone: *

XXX-XXX-XXXX

Work Telephone: *

XXX-XXX-XXXX

Work Telephone Extension (if required):

Preferred Telephone Contact: *

Street Address: *

City: *

State: *

Zip: *

Secondary Owner's First and Last Name:

Additional People who my pets maybe released to. We will only release pets to you or your assigned agents.:

Emergency Information

Emergency Contact Name: *

Emergency Contact'sTelephone: *

XXX-XXX-XXXX

PET INFORMATION

Pet Name: *

Type: *

Dog

Cat

Color: *

Size: *

Sex: *

If female, when was your pet's last cycle:

Breed: *

Weight: *

Date of Birth: *

My pet is spayed/neutered : *

In order to be accepted into Daycare, your pet must be spayed or neutered!

My pet has the following identification: *

Markings:

Disabilities (if any):

YOUR PET'S BEHAVIOR

Describe your pet's interaction with people: *

If other type of interaction with people, please describe:

Describe your pet's temperment: *

If other temperment, please describe:

Does your pet have any behavioral issues?: *

If your pet has behavioral issues, please explaine:

Has your pet ever bitten or been bitten?: *

If yes, please explain:

Has your pet attended daycare before?: *

If yes, when and where? If no, type "N/A".: *

Has your pet ever attended obedience training?: *

If yes, when and where. Also, please describe the outcomes of the training:

Does your pet know basic commands?:

Sit

Stay

Come

Check all that apply.

Is your pet house trained?: *

Is your pet crate trained: *

YOUR PET'S HEALTH

Veterinarian

Veterinarian Name: *

First Name, Last Name

Clinic Name: *

Clinic Address:

Street Address, City, State, Zip Code

Clinic Telephone Number: *

(xxx)xxx-xxxx

Clinic Fax Number:

(xxx)xxx-xxxx

Please describe your pet's general health. Include any current medical conditions.

Allergies:

Current Medications:

Frequency and time medication is administered:

Date of last complete physical examination: *

Date of last fecal exam: *

Vaccinations

Rabies

Date Administered: *

Date Due:

DHLP

Date Administered: *

Date Due:

Parvo

Date Administered: *

Date Due:

Bordatella

Date Administered: *

Date Due: *

Heartworm Medication

Date Administered: *

Date Due:

Flea & Tick Control

Method Used: *

YOUR PET'S DAILY LIFE

Wake Up Time:

Regular Brand & Variety of Food:

Food Type:

Dry (hard)

Dry (moist)

Wet

Quantity of food per feeding:

List all feeding times:

Regular walking times:

Exercise instructions:

Sleep times:

Typical waste elimination times:

Instructions, Concerns, or Special Needs: