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To print this form, you may select the text (beginning at Pet Information Sheet and continuing to the end of the last line). Once text is selected, go to File (top left of your browser screen) and select print. When the print box is open, click the option that says Print Selection. From my computer and using Microsoft's Internet Explorer, this prints as a two-page form. One form will need to be filled out for each pet that will be under the care of a Coddled Critters In Home Pet Service Provider.

 

Coddled Critters In Home Pet Services
281-728-9001 * animezu@yahoo.com
www.animezu.com/coddledcritters.htm
BONDED AND INSURED
Member PSI, HAPPSA and NAPPS

PET INFORMATION SHEET

Client Name: ______________________________

Pet's Name: ____________________ Weight _____

Species ________________ Color _______________

Sex: M F xxxxxxxxxx Altered: Y N

Age _______ Birthday___________

Is your pet Current on ALL Shots? Yes No
If not please explain:

Does your pet have and wear a collar with rabies tag attached? Yes No
Rabies Tag Number:

Specific feeding instructions:

Treats? Where are they kept and How many?

Are there any current diseases, illnesses or disabilities? Yes No
If yes, please give pets name and description of problem

Does your pet need medications administered? YES NO
Describe any medication procedures and the name and dosage of the medication as well as where it is kept.

Special cleaning instructions for any accidents & location of supplies:

Does your pet have a special hiding place or places?

Is there something that will bring your pet out of hiding (the sound of the can opener or treat jar, for example)?

Does your pet have a favorite game, toy or words?

Is your pet kept in a cage? YES NO
Will the cage need to be cleaned during my service?

Special cleaning instructions for cage & location of supplies:

Does your pet have a litter box that requires changing during my service? YES NO
Litter Box Location?

Special cleaning instructions for litter box & location of supplies:

 

Please answer the following brief questionnaire about your pet. It will help us to better care for him/her:
Is friendly with other pets YES NO
Likes new adults YES NO
Likes children YES NO
Tries to escape? YES NO
Will not eat when stressed? YES NO
Fearful of loud noises? YES NO
Likes to be petted? YES NO
Likes to be held? YES NO
Is allowed out of the cage YES NO
Is allowed in the house YES NO
Is allowed on the furniture YES NO
Is prone to chewing YES NO
Is fearful of noises or other things YES NO
Has bitten people or other pets YES NO
Has shown other aggression YES / NO

Please indicate anything else about your pet's habits or behavior that would be useful to us in providing care: