Pre-registration

                                             Good Paws Bed & Biscuit, Inc.
                                                      Pre-registration Form

Owner Name:__________________________________   Date:_____________

Address:________________________________________________________

Phone:_______________   Alternate Phone_______________ e-mail ____________________

Emergency Contact/alternate pickup__________________________________________
_______________________________________________________________________

Pet Name____________________ Breed/Color__________________ Sex___________

DOB___________________ Height________________ Weight______________

Altered Status____________   Distinguishing Marks_________________________

Veterinarian________________________ Phone:________________________

Brand Food Provided:__________________ Feeding Instructions_________________

Belongings______________________________________________________________

Medical Notes:___________________________________________________________

Special Needs:____________________________________________________________

Check-in Date:_____________________   Check-out Date:_____________________

Suite size___________ Special Services (extra fee)____________________________

______________________________________________________________________

Vaccinations: (copy of records is required)

__________ Bordetella (within 6 months)
__________ Coronavirus
__________ DHLPP – distemper, hepatitis, leptospirosis, parainfluenza and parvo virus.
__________ Rabies

Signed ______________________________________ Date:______________________

Print this page and send to Good Paws Bed & Biscuit for Pre-registration.
FAX 795-5399