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Client Information:
Name:
E-mail:
Street address:
City:
State:
Zip:
Home phone:
Work phone:
Cell phone:
Fax:


Pet Information:
Pet's name:
Birthday:
Weight:
Breed:
Sex: Male or Female
Spayed or neutered? Yes or No


Pet's Medical Information:
Vet clinic name:
Vet's name:
Dog vaccines required (see Articles of Interest)
Cat vaccines required (see Articles of Interest)
Titers test results are also accepted at Golden Lake Recreational Pet Camp


Medication:
Heartworm given? Yes or No Date given (if yes):
Flea prevention given? Yes or No Date given (if yes):
Other medications (ear meds, eye meds, thyroid meds, allergy meds, rimadyl, glycoflex, phenobarbital for seizures, etc.)


Diet & Feeding:
Brand of food (Iams, Science Diet, Nutromax, Pro Plan, other):
Type of food (puppy, adult, low calorie, etc.):
Number of feeding times per day:
Amount per feeding:
Treats: Biscuits Rice cakes Carrots


Additional Comments:
Examples: food spiller, water spiller, sloppy drinker, afraid of thunderstorms, afraid of vacuum, afraid of loud noises, good with other dogs, good with people, loves to be held, etc.


How did you hear about us?





© Golden Lake Recreational Pet Camp
210 Andersontown Road  Mechanicsburg, PA 17055 (717) 691-1850 Fax (717) 691-0152