Kennel Guest Check In


Please use separate form for each pet

Owner's Name *
Address *
City
State
Zip code
Phoneexample: 555-555-5555
  Home *
  Work
  Cell
Email
Guest Name *
Sex M/FMale Female
Color
Spayed/Neutered Y/NYes No
DOB
Weight
Breed *


Veterinarian
Name
Practice Name
Address


How did you find out about Tail Waggers of Litchfield?

Any known allergies i.e. shampoos, perfumes, types of food etc.?

Please list any pre-existing medical conditions:

Brand of pet food both dry and/or canned that you feed at home?

What kind of protein source (main ingredient in food), e.g., beef, chicken, lamb etc.

Do you raise the food or water levels (higher than the pets chest level)? Yes No

How many times a day do you feed 2x or 1x?
If 1x, is that am/pm only?

How much dry food by measured cup per serving:

Daily total dry food by measured cup:

Do you mix the kibble with canned food or water, if so, how much?

Special diet? Explain

Please indicate long-term medicines or supplements to be dispensed including name, what its prescribed for, and the instructions:
Medication/Supplement: Prescribed/Used for: Dosage: Administered by:
Medication/Supplement: Prescribed/Used for: Dosage: Administered by:
Medication/Supplement: Prescribed/Used for: Dosage: Administered by:
Medication/Supplement: Prescribed/Used for: Dosage: Administered by:

Tell us about your pet, what should we know so that we may provide the best care to him/her?



Has your pet been kenneled before? Were there any behavioral/medical concerns that you were made aware of?

If yes, please Explain:
Are there any food possession/ toy possession issues?
YES, with other animals YES, with humans with both humans & animals
Please list dates of stay *


MULTI PETS: Pets sharing the same run or residing at the same time:


When sharing a run, do they need to be supervised/separated during feeding? YES No
If in separate runs, can they play together during exercise? YES No

Date Filled Out: