Prefer to fill out the form on paper? View Printable Version (When finished, contact us to submit the paper copy) General Pet Information If you are human, leave this field blank. Pet #1 Information: Name: * First Name: * Last Age: * DOB: * Weight: * Gender of Pet * Male Female Choose an Option: * Intact Spayed Neutered Breed: * Color/Markings: * Allergies: * Pet #2 Information: Name: First Name: Last Age: DOB: Weight: Gender of Pet Male Female Choose an Option: Intact Spayed Neutered Breed: Color/Markings: Allergies: Pet #3 Information: Name: First Name: Last Age: DOB: Weight: Gender of Pet Male Female Choose an Option: Intact Spayed Neutered Breed: Color/Markings: Allergies: Owner Information: Name: * First Last Name: * Last Address: Street Address Address: * City, State ZIP Code Home Phone: * Cell: * Work: * Email: * Cellular Carrier: * Persons authorized to pick up your pet(s): * Separate each with a comma... Does your dog(s) have a tendency to chew things?: * Yes No Emergency Contact: (responsible for decisions if owner not available) Name: * First Last Name: * Last Home Phone: * Cell: * Work: * Vet Information: Vet Clinic: * Phone: * Veterinarian Name: * Will your pet need vaccinated prior to coming to Paws-a-Palooza? * Yes No Is your pet on flea/tick prevention treatment? * Yes No Is your pet on heartworm preventative medication? * Yes No Day Camp / Boarding Questions: 1) Do you plan on using our day camp service when it opens? * Yes No If yes, how often might you use this service? * Daily 1-2 times per week 3-4 times per week If yes, how long, generally, would your pet be at day camp? * 1-4 hours (half day) 4+ hours (whole day) 2) Do you plan on using our overnight boarding service when it opens? * Yes No If yes, would you be boarding more than 1 dog each time? * Yes No If yes, would you want all the dogs boarded in the same suite? * Yes No How often do you currently use a dog boarding service? * Monthly 3-4 times a year 4+ times a year Never Submit Questions/Issues? Contact us!