Animal Information. Veterinarian: Phone: Address: City: State Zip Pet Name: Breed: Color: [ ] Male [ ] Female Date of Birth: Please check all that apply to your canine/feline: Aggressive [ ] Barks [ ] Chews [ ] Climbs Fences [ ] Digs [ ] Separation Anxiety [ ] Stool Eater [ ] Bites [ ] Gathers/Guards Toys [ ] Guards Food [ ] Pet Name: Breed: Color: [ ] Male [ ] Female Date of Birth: Please check all that apply to your canine/feline: Aggressive [ ] Barks [ ] Chews [ ] Climbs Fences [ ] Digs [ ] Separation Anxiety [ ] Stool Eater [ ] Bites [ ] Gathers/Guards Toys [ ] Guards Food [ ] Pet Name: Breed: Color: [ ] Male [ ] Female Date of Birth: Please check all that apply to your canine/feline: Aggressive [ ] Barks [ ] Chews [ ] Climbs Fences [ ] Digs [ ] Separation Anxiety [ ] Stool Eater [ ] Bites [ ] Gathers/Guards Toys [ ] Guards Food [ ] (Additional Pets can be added upon request) Any additional habits or behaviors the Club should know about prior to boarding your Dog/Cat(s): . Any health or medical issues we should know about prior to boarding the Dog/Cat(s) (e.g., vision or hearing loss, allergies, seizures, arthritis): .
Animal Information. Species: Strain: Females/number: Males/number: Have any animals undergone surgical procedures? Yes No If yes, please explain: Have animals been genetically altered or infected with pathogens, parasites, etc.? Yes No If yes, please explain:
Animal Information. General History: Why are you surrendering your pet today? _______ Are you aware of our free behavior helpline service that provides you with resources and advice to help correct behavior problems? No Yes If we could help you resolve the issues surrounding the surrender of your pet would you be interested in keeping your animal? ____ If yes, please stop here and speak with a member of our Admissions staff. Dog’s Name: Nickname: Age or approximate age: How old was this dog when you acquired him/her? Is this dog a Male Female Unsure Has this dog been spayed or neutered? Yes No Unsure Has this dog been microchipped? Yes No Unsure How long have you owned this dog? Including your home, how many homes has this dog had? _______ Where did you acquire this dog? XXXX Another shelter Found as a stray Friend/Relative Pet store Breeder Free-to-good-home ad Born in my home Other Medical History: Did this pet receive annual exams by a veterinarian? Yes No Unsure Name of Veterinarian: Is this dog current on his/her rabies vaccination? Yes No Unsure Does this animal have any medical problems or previous Yes No Unsure injuries that require special attention or a special diet? Explain: Please check all conditions that your dog has been diagnosed with or has been treated for: Allergies Urinary Tract Infection Kennel Cough Epilepsy/Seizures Thyroid Disease Skin Problems Ringworm Diabetes Organ Failure Heart murmur Parvovirus Heart Worms Obesity Other: How does this dog behave at the vet’s office? Calm, relaxed Anxious, but calms down Anxious, nips and growls Very stressed, must be muzzled to avoid biting Personality Profile: Check all traits that best describe your canine friend’s personality: Very energetic Shy to strangers Shy with some family members Talkative Playful Friendly/affectionate to family members Independent Affectionate Lap dog – loves attention Fearful A loner Stubborn Goofball Lazy – Couch Potato Other What’s your dog’s most favorite style of play (check all that apply)? Very gentle Enjoys playing fetch Likes to play with other dogs Likes to play with cats Xxxx learn tricks for treats VERY energetic and rambunctious Doesn’t show a great interest in playing Likes to play with toys Other: Lifestyle & Home Life Was this dog (check all that apply): Indoors except to potty Outdoors during the day, in at night In and out throughout the day: hours outside: __________ hours inside: __________ Outside 24 hours This dog sleeps (check all that apply): Inside, on the floor...
Animal Information. Filled out completely
Animal Information. There is a Dog Park located on the property where you can take your animal and let them run off-leash within the park. YOU MUST BE WITH YOUR ANIMAL AT ALL TIMES. Refer to section 2.4 of this contract for specific information regarding Service Animals and Pet Sitter Designation requirements.
Animal Information. You will need to show proof of current vaccinations and spay/ neuter verification. All animals must have a collar with tags and pet interview may be required in advance of move in. Animal deposits are refundable within 30 days of move out less any damages. All animals must abide by the City of Nacogdoches Leash Laws. Your animal must be on a leash at all times when outside your home, with you firmly in control of the animal and may never be tied to a tree or any other object. The leash must be firmly in your hand at all times. Animal waste receptacles are provided throughout the property. Animal waste can cause health issues .please pick up after your animal. Fines for not picking up your animal waste will begin at $30 and increase based on the number of violations. You must remove an illegal animal within 24 hours of notice from TVN, or you will be considered in default of this Housing Contract. If an occupant or any guest violates animal restrictions (with or without your knowledge), you will be subject to charges, damages, 24 hour notice to vacate, and other remedies provided in this Housing Contract. If an animal has been in the home at any time during your term of occupancy (with or without our consent), MLF will charge you for de-fleaing, deodorizing', and shampooing. Residents will be jointly and severally liable for the entire amount of all damages caused by the animal. If any item cannot be satisfactorily cleaned or repaired, Residents must pay for complete replacement of such item. Animal odors and stains are "extraordinary damage" and NOT "normal wear and tear." Resident will be strictly liable for the entire amount of any injury to any person or property caused by the animal, and shall indemnify TVN for all costs of litigation and attorney's fees resulting from such litigation.
Animal Information. Name Birth Date DOG CAT Neutered Male Spayed Female Unaltered* *(additional boarding fees may apply) under 7 months of age Breed: Select Color Current on ALL vaccinations Y / N (RABIES, DHLP- PARVO, BORDATELLA REQUIRED FOR DOGS/ RABIES, FELINE DISTEMPER FOR CATS) Method of Flea/Tick control (ALL PETS MUST BE ON PREVENTATIVE AND FREE OF FLEAS) When Last Given Select Health conditions that require routine medication or treatment Y / N IF YES, LIST MEDS Has your pet ever been boarded elsewhere? SY /eNlec Have they done well? XxXx/eNct Are there ANY medical or behavioral issues or concerns, allergies, or physical limitations we should be aware of, please explain (EX, fear of storms, chews, guards food, aggressive) Has your dog ever jumped a fence SelecYt/ N Has your pet ever bitten or attacked another animal or person SY e/ Nlect Has your animal ever exhibited aggressive behavior towards another person or animal SY /eNlect SHOT VERIFICATION BY STAFF R D B If YES, explain REVISED 01/2017 PAWJAMA PARTY TERMS OF AGREEMENT PLEASE INITIAL NEXT TO EACH STATEMENT AND SIGN THE BOTTOM
Animal Information. Animal Name: Animal Type: Animal Breed: Animal weight/height: Animal Age: Animal Description/Color:
