Owner Name*

First Last

Pet Name*

Pet Age (or best guess)*

Species*

Breed (best guess if mixed)

Color*

Gender*

Neutered*

Spayed*

Weight (or best guess)*

Current Veterinary Clinic / Hospital; Please have them send a copy of your pet's medical history*

Behavior Information

Behavior with people?*

If “other” please explain

Behavior with other pets?*

If “other” please explain

Has your pet ever bitten a human or another pet?*

If “yes” please explain

Has your pet ever boarded at any facility before?*

Does you pet have a history of diarrhea when change or stress occurs?*

Do you give CCVRS permission to withhold your pet’s food for a day should he/she have diarrhea?*

Has your pet ever tried to escape by (check all that apply)*

Does your pet have a fear of any of the following? (check all that apply)?*

Does your pet have any allergies or medical conditions? If yes, please explain.

(If your pet has never boarded at any facility, please call out staff to set up a meet and greet prior to making reservations)

Pet Registration