Client and Pet Information Form – Canine Performance

Client Name *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Cell Phone *
Email *
Preferred way to be contacted: *
Security System / Alarm / Camera *Please provide detailed information if planning on using during our visit.
Garage Code (if used as primary way of entrance or incase of emergency):
Primary Vet Name & Number:

Pets Name: *
Age: *
Breed: *
Male or Female: *
Spayed/Neutered: *
Health Concerns: *
Please list any and all health concerns. (had surgery on ACL 2 years ago, prone to ear infections, etc)
Medications: *
Please list any and all medications. We reserve the right to refuse service to any pet for any reason including, without limitation, if it appears that the pet is sick, injured, in pain, or that its behaviour could jeopardize the health and safety of other pets or our staff.
Favorite games/toys: *
Hiding places: *
Indoor/Outdoor instructions: *
Any behavior or problems to be aware of: *
Preferred Walk Time
*Dog Walking Clients - Time of Service (please allow 2hour window)10am-12pm12pm-2pm2pm-4pm
Services Interested In: *
Regularly Scheduled Midday Dog WalkingRandom / Last Minute Midday Dog WalkingAfter Hour Walks / Pet-Sitting / Boarding
Pet(s) Date of Birth *
In the unlikely event your walker/sitter (and backup) has a personal emergency and we can’t get ahold of you, who do you know we could have visit your pet? *
*Please do NOT list yourself.* Contact Name & Phone Number