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New Client Form

New Client Information
Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Home Phone
Work Phone
Cellular Phone
Email*
Emergency Contact Information
In the event that an emergency arises and you’re not reachable, please provide the information of someone who we can contact.
Name*
First Last
Home Phone
Work Phone
Cellular Phone
Pet Information
Pet Information*
Name Breed Gender Age Weight Birthday (If unknown please choose a date you would like it to be)

To add additional pets please click the + sign
Feeding Instructions*
Morning - Indicate Amount Of Food Noon - Indicate Amount Of Food Evening - Indicate Amount Of Food

To add additional feeding please click the + sign
Medical Information*
Is your pet spayed or neutered? List any medical conditions List any medications or supplements List any allergies

To add additional pet information please click the + sign

Behaviour Information*

Is your pet good with other animals?	Does your pet have separation anxiety or anxiety?	Are there any special things we need to know about your pet? (ex. jumps fences, digs holes, bad chewer, not crate trained)?

To add additional pet information please click the + sign

Veterinary Information
Veterinary authorization forms will be sent via email once we contact you to confirm services. These forms must be completed before services begin.
Clinic Name*
First
Veterinarian Name*
First
Phone Number
Service Information
Service Required
- Daycare
- Overnight Boarding
- Grooming
- Spa Day
- Off Leash Group Dog Walks
- Individual Dog Walks
- Cat Sitting
- Dog Sitting
- Birds and Small Animal Care
- Other
If other, please indicate
Dates Needed For Service
Drop Off Date*
Date Format: MM slash DD slash YYYY
Pick Up Date*
Date Format: MM slash DD slash YYYY
How Did You Hear About Us?
Consent*
I understand
Dogaholics Policies and Procedures and Vet Authorization forms will be sent via email once we contact you to confirm services. These forms must be completed before services begin.
CAPTCHA

Name	Breed	Gender	Age	Weight	Birthday (If unknown please choose a date you would like it to be)

Morning - Indicate Amount Of Food	Noon - Indicate Amount Of Food	Evening - Indicate Amount Of Food

Is your pet spayed or neutered?	List any medical conditions	List any medications or supplements	List any allergies

If other, please indicate

New Client Information