Please Complete Fully for Our Permanent Records

Puptown Lounge Client Profile

Please complete fully for our permanent records Prior to subsequent visits – Please let us know if any of this information changes

Client Name ______

Address ______

City ______Zip Code ______Wk Phone ______

Hm Phone ______Mobile Phone______

Other______E-mail ______

Emergency Contact ______Relationship ______

Phone ______

Pet Profile(s)

Pet 1 Name ______Age ___ Sex M/F? ____ Spayed/Neutered?______

Species (Dog, Cat, Etc.)______Breed ______

Pet 2 Name ______Age ___ Sex M/F Altered? ____ Species ______Breed ______

Pet 3 Name ______Age ___ Sex M/F Altered? ____ Species ______Breed ______

Food: Type / Amount / How Mixed / Feeding Schedule / Any Special Instructions

Food 1: ______

Food 2: ______

Food 3: ______

Favorite Treats: how often/when: ______

Favorite Activities / Toys: ______Puptown Lounge

Training/Obedience/Commands: ______

Is there a magic word for pee/poop?______

How is your dog on lead?______

Medications and instructions to administer: ______

Are vaccinations current? Yes ____ No ______If no please explain: ______

Temperament/attitude toward strangers, check all that apply: Excited __ Friendly ____ Aloof ____ Cautious ______Stressed ____ Scared/Defensive _____ Aggressive ____ Indifferent ______

Dog/dog social skills/attitude; dog park or day care experience? ______

Has pet ever bitten anyone or acted aggressively toward anyone? Yes __ No ____ If yes please explain: ______

Physical conditions or problems to watch for/be aware of/house training or reliability of bladder/bowel control:______

Please describe your pets’ normal eating/exercise/elimination routines ______Puptown Lounge

Veterinary Information

Name of practice/hospital ______

Primary vet’s name ______

Address ______City ______

Phone ______

In the event of a health emergency, Puptown Lounge may exercise discretion in seeking veterinary care, preferably to the above named veterinarian, should time allow. If our primary veterinarian is not available, or it is after normal business hours, Puptown Lounge has permission to take my pet to the nearest emergency animal clinic. I understand that I am responsible for the entire cost of care.

Pet Guardian ______Date ______(Signature)

PLEASE ATTACH A COPY OF YOUR PETS’ M OST RECENT VACCINATIONS Puptown Lounge

RULES AND REGULATIONS OF PUPTOWN LOUNGE

1. Boarding your pet at Puptown Lounge includes group socialization play time which could expose your pet to injuries and virus/disease be transmitted. I also understand that Puptown Lounge has daily cleaning and weekly disinfestations routines to prevent spreading virus/disease. 2. All animals must be spayed or neutered to participate in day care activities. 3. Puptown Lounge requires proof of vaccination against Rabies and Bordetella (kennel cough). Rabies is required for all pets and Bordetella shots are only required for dogs. Notice of any recent or ongoing medical conditions or issues must be provided to Puptown Lounge in writing prior to your pet’s stay. 4. Puptown Lounge provides supervision at all times when your pet is together with other animals in the facility to prevent accidents that could cause injuries to your pet. If confirmed that injury was caused because Puptown Lounge did NOT provide proper supervision and care, Puptown Lounge will be responsible for veterinarian expenses. 5. Puptown Lounge will attempt to contact you in an event of an accident or sickness at the phone number provided at the time of the reservation. If you cannot be reached at that number, we will contact your veterinarian at the facility you have provided. In case of extreme urgency, Puptown Lounge will transfer your pet to its on-call veterinarian facility. You will be responsible for any extraordinary expense incurred by Puptown Lounge as to your pet, such as veterinarian costs. These expenses do not include ordinary expenses such as your pet’s food and water. In the unlikely event of your pet’s illness, injury, or loss caused by Puptown Lounge, Puptown Lounge’s liability is limited to your economic loss. 6. If your dog displays aggressive behavior, for the safety and health of your dog and others, your pet may be confined to a kennel or be muzzled for the remainder of his/her stay with no offset or deduction in price. Puptown Lounge assumes no responsibility for harm caused by your pet to a third person or other animal. You will be solely responsible for any harm caused by your pet to any other person or animal while on Puptown Lounge’s property.