dog form

omaha’s urban pet care

save some time...

...fill this out online. If you have two or more dogs, please use a separate form for each.

*Client Name

*Email

Street Address

Apt

City

State

ZIP

Home Phone

Work Phone

Cell Phone

Dog name

Dog age

Dog breed

Color

Sex

Neutered

Rabies Tag #

Vet Name

Vet Phone

Emergency contact

Do you have pet insurance?

Special Feeding Instructions

Is your dog taking any medications?

How and when are they given?

Do you want your dog to be walked?

Does your dog have favorite hiding places?

Where?

Does your dog try to escape?

How?

Does your dog dig?

Has your dog ever run away?

Does your dog eat when stressed?

Has your dog ever bitten?

If so, please explain the circumstance

Does your dog like to be held, petted or brushed?

Instructions

Please describe your dog’s temperament around strangers, adults or children

Is your dog allowed to have treats?

What Kind?

Please tell us any other habits or behaviors your dog has that would help us in providing the best care while you are away