Client Contact Information
Name *
Name
Please list primary contact person from household
Phone
Phone
Home Address
Home Address
Name 2
Name 2
Please list secondary contact person from household.
Phone 2
Phone 2
VET & EMERCENCY CONTACT INFORMATION
It is recommended that you leave a credit card on file with your vet.
Vet Phone
Vet Phone
Please list one or two people to contact in the event of an emergency if you are unreachable.
Emergency Contact Phone
Emergency Contact Phone
Emergency Contact #2 Phone
Emergency Contact #2 Phone
PET INFORMATION
In the following section please list the required information about your pets.
Sex
Date of Birth
Date of Birth
Spayed/Neutered *
Please list any injuries, illnesses, treatments or medications.
Please include information about what kind of food your dog eats, feeding schedule, amount of food given, if there are any special feeding needs, etc.
Please list anything you'd like known about your pet such as favorite games, personality, temperament info, feeding information, restrictions, etc.
Sex
Date of Birth
Date of Birth
Spayed/Neutered
Please list any injuries, illnesses, treatments or medications.
Please include information about what kind of food your dog eats, feeding schedule, amount of food given, if there are any special feeding needs, etc.
Please list anything you'd like known about your pet such as favorite games, personality, temperament info, restrictions, etc.
If you have more than two pets, please list additional pets in the box below. Please include name, date of birth, medical history, etc.
SERVICES REQUESTED *
Please check all that apply. To see a list of services available and rates, please visit: http://www.lonestarleash.com/services-rates/
Please list any additional information about your pets and/or services you need or anything else you would like Lone Star Leash Services to know. This can include what you would like done during your pet's visit or stay, house information, etc.
Photos of Pets *
With your permission, we love to share photos of your pets on our Facebook page, other social media and on our webpage. We do not share location or detailed information about your pets or any other personal information. Please select the appropriate option below.
Link to terms of service is located below.
Today's Date *
Today's Date