Pet Information Form

I. Owner Information

First Name:

Last Name:

Street Address:

City:

State:

Zip Code:

Email:

Phone Number (Primary):

Phone Number (Secondary/Emergency):

Emergency Contact:

First Name:

Last Name:

Phone Number:

Email:

II. Pet Information (General)

	Pet's Name	Species (Dog, Cat, Bird, etc.)	Breed (if applicable)	Age	Date of Birth	Sex	Color(s)	Identifying Marks/Features	Microchip No.	Tattoo/Other Identification
	A	B	C	D	E	F	G	H	I	J
1
2
3
4
5
6
7
8
9
10

III. Pet Health Information

Veterinarian's Full Name:

Veterinarian Clinic Name:

Veterinarian Clinic Phone Number:

Known Allergies:

Current Medications:

	Name	Dosage	Frequency
	A	B	C
1
2
3
4
5
6
7
8
9
10

Medical Conditions:

Vaccination History:

	Date	Type
	A	B
1
2
3
4
5
6
7
8
9
10

Heartworm/Flea/Tick Prevention:

Special Dietary Needs:

Any Behavioral Issues:

Last Vet Visit Date:

Has your pet ever had a blood transfusion?

Yes

Is your pet on any long term medications?

Yes

IV. Pet Behavior/Habits

Temperament:

Socialization:

Feeding Schedule:

Favorite Food/Treats:

Potty Training/Litter Box Habits:

Exercise Routine:

Favorite Toys/Activities:

Any Fears or Phobias:

Any specific commands your pet knows?

Does your pet have any destructive habits, and what are they?

V. Emergency/Care Instructions

In case of emergency, what are your instructions?

Is your pet allowed to have certain treats?

Yes

What are they?

Any specific handling instructions?

Any other important information we should know?

Form Template Instructions

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Strengths:

Comprehensive Coverage:

It covers all the crucial aspects of pet ownership: owner details, pet identification, health, behavior, and emergency procedures.
This thoroughness ensures that you have a complete picture of the pet and its needs.

Clear Organization:

The form is logically divided into sections, making it easy for owners to understand and complete.
The section headings are clear and descriptive.

Essential Information Gathering:

It gathers vital information for emergency situations, such as emergency contact details and specific instructions.
Medical history and current medications are thoroughly addressed, which is critical for the pet's well-being.
Behavioral questions allow for proper care and handling of the animal.

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