PET #1

PET #2

PET # 3

Name

 

 

 

Species (cat, dog)

 

 

 

Breed

 

 

 

Description (color)

 

 

 

Age (year)

 

 

 

Date of birth

 

 

 

Sex

 

 

 

Length of time owned

 

 

 

Altered or Spayed

 

 

 

Vitamins (type)

 

 

 

Diet (kind of pet food)

 

 

 

Type of grooming products

 

 

 

Hours spent outside each day

 

 

 

Vaccinations:

 

 

 

DHLP(distemper-dog)

 

 

 

Parvovirus (dogs)

 

 

 

FVRCP (infectious diseases-cats)

 

 

 

Rabies (cat/dog)

 

 

 

Feline Leukemia Test

 

 

 

Other Vaccines

 

 

 

Heartworm Test

 

 

 

Heartworm Prevention

 

 

 

Fecal Exam(worms-dog/cat)

 

 

 

Denistry

 

 

 

Prior Illness

 

 

 

Prior Surgery

 

 

 

PET ORIGIN:(circle)  Humane Society,    Pet Shop,          Kennel,         Advertisement,              

                                       Friend,          Stray,          Individual (non-breeder)   or    Breeder