First Name

Last Name

Address

City

State

Zip

Nearest Cross Streets

Phone Number

Email Address

Name of Pet

Pet's Birthday and/or Age

Sex of Pet

Breed

Weight of Pet

Spayed/Neutered? Spayed/Neutered? Yes No

Color/Distinctive Markings

Health Concerns

Veterinarian

Vet Address

In case of an emergency, contact:

Person(s) with access to your home/office:

Phone of Building Service:

How would you describe your pet's personality?

Has your pet ever snapped at or bitten anyone? Has your pet ever snapped at or bitten anyone? Yes No

Please describe the situation:

Is your pet good with children? Is your pet good with children? Yes No Unsure

Does your pet have a history of biting or fighting with other animals? Does your pet have a history of biting or fighting with other animals? Yes No

Can you groom your pet? Can you groom your pet? Yes No

Are you aware of any reason we should approach your pet with caution? Are you aware of any reason we should approach your pet with caution? Yes No

How does your pet react to your absence from home?

How does your pet react with regard to food?

Does your pet like to be brushed? Does your pet like to be brushed? Yes No

What are your pet's favorite toys?

What are your dog's favorite walking routes?

What are your pets daily feeding instructions?

Where do you keep your pet supplies?

Where do you keep the cleaning products?

Where do you dispose of garbage?

By submitting this form, I agree to the following: By submitting this form, I agree to the following: I give my permission to It’s A Dog’s Life, LLC (the “Company”) to enter my residence or office in order to provide quality pet care for my animal(s). Please allow this organization to perform this service and give the Company all necessary assistance in regards to this matter. During my absence, I hereby authorize It’s A Dog’s Life, LLC or their designated agent(s) to seek medical treatment for my animal(s). I will remain responsible to pay all such medical expenses whether directly to the provider of the medical treatment or to It’s A Dog’s Life, LLC within five (5) days of the date on which such expenses are incurred.

Other pertinent information: