Client Information This form is only for already existing clients adding a new pet to our recordsClient's Name(Required) First Last Pet Guest InformationPet guest type Dog Cat Dog InformationDog's Name(Required) Primary Breed(Required) Weight(Required) Color(Required) Age/Birthdate(Required) Check all that apply:(Required) Male Female Spayed Neutered Unaltered Has your dog ever attended a daycare or boarding facility in the past?(Required) Yes No Has your dog ever bitten another dog or person?(Required) Yes No If yes, please explain:(Required) Has your dog displayed any of the following reactions? (Please check all that apply) May bite Growls Snaps Shows teeth Trembles Freezes Moves away Your dog plays best with: No Dogs Big Dogs Little Dogs Older Dogs Puppies Cat InformationCat's Name(Required) Primary Breed(Required) Weight(Required) Color(Required) Age/Birthdate(Required) Check all that apply:(Required) Male Female Spayed Neutered Unaltered Is your cat litter box trained?(Required) Yes No DOG MEDICAL HISTORYIs your dog currently taking any medications?(Required) Yes No NOTE: IF CHECKED YES, PLEASE COMPLETE AND SIGN A MEDICATION ADMINISTRATION FORM FOR EACH PET The Pawington cannot offer services to dogs with seizures, congestive heart failure, significant heart murmurs, and other serious health conditions. For these ailments, please use a medically prepared veterinarian. We apologize for the inconvenience. Please inform us prior to any visit if your dog is experiencing coughing, sneezing, or GI issues.Does your dog have any previous or current injuries, physical problems or health concerns, including allergies?(Required) Yes No If yes, please explain:(Required) Does your dog have any physical restrictions while playing, or sensitive area on the body?(Required) Yes No If yes, please explain:(Required) DOG VACCINATION REQUIREMENTSThe Pawington requires these vaccines for dogs: Rabies DHLPP Bordetella (if never received, must be administered 7+ days prior to services) CIV (Canine Influenza Virus - first shot is required prior to using services) To upload your vaccine records, you can use the online form on our website at https://thepawington.com/vaccine-form/. If your records are unavailable, you can request our front desk contact your vet. Titers for some vaccines may rarely suffice on a case by case basis, contact our front desk. Is your dog currently on a flea preventative medication? (Required for all guests)(Required) Yes No Date it was last given:(Required) If The Pawington finds evidence of ticks or fleas, necessary treatment will be provided at owner's expense.Shampoo Selection The Pawington administers free departure baths for guests boarding for 7+ nights.You may change this selection at any time by speaking to our front desk.Shampoo preference Oatmeal Shampoo & Conditioner Hypoallergenic Tearless Plum Shampoo CAT MEDICAL HISTORYIs your cat currently taking any medications?(Required) Yes No NOTE: IF CHECKED YES, PLEASE COMPLETE AND SIGN A MEDICATION ADMINISTRATION FORM FOR EACH PETAre any of these medications for their heart or seizures?(Required) Yes No Is your cat displaying any symptoms such as coughing, sneezing, or upset stomach?(Required) Yes No Does your cat have any previous or current injuries, physical problems or health concerns, including allergies?(Required) Yes No If yes, please explain.(Required) Does your cat have any physical restrictions while playing, or sensitive areas on the body?(Required) Yes No If yes, please explain.(Required) CAT VACCINATION RECORDSPlease list the current expiration dates for the following vaccinations (for indoor cats, a waiver for FELV may be submitted by your vet.) The front desk can contact your vet directly for proof of vaccines if needed.Rabies expiration date(Required) FVCRP expiration date(Required) FELV expiration date(Required) Is your cat currently on a flea preventative medication?(Required) Yes No Date it was last given:(Required) CAT PERSONALITYPlease check all answers that describe your cat's personality:(Required) Outgoing Timid Affectionate Reserved Fiesty Friendly Independent Playful Confident Submissive Clingy Gentle Other If Other, please describe.(Required) Please check all answers that describe your cat's attributes:(Required) Likes to scratch Fears noises Meow's excessively Separation anxiety Low activity level Medium activity level High activity level Other If Other, please describe.(Required) I, the undersigned, hereby acknowledge and agree that all of the information is complete and accurate to the best of my knowledge. I further attest that if I am not the sole owner or representative of the dog subject to this application, that my signature is sufficient to enter into this application for and on behalf of any other owner or representative.Client Signature(Required) Reset signature Signature locked. Reset to sign again Date(Required) Vaccine InformationFor your convenience, The Pawington's front desk can retrieve records from your veterinarian if desired, or you can upload your vaccine records here. I want to upload my own vaccine records I want The Pawington to contact my vet for vaccine records Client's Name(Required) First Last Email(Required) Pet's Name(Required) Dog - Vaccines Administered (if known) Rabies DHLPP Bordetella CIV (Canine Influenza) Cat - Vaccines Administered (if known) Rabies FVRCP FELV (waiver available for indoor cats only) Vaccine Records Drop files here or Select files Max. file size: 25 MB, Max. files: 5. Veterinarian Clinic Used for Vaccines City of Clinic Clinic's Phone Number (if known) NameThis field is for validation purposes and should be left unchanged. Δ
