.

 

This comprehensive registration form is designed to give us the most accurate and up-to-date information about your pet. It is important for both you and your dog that Cara Mia is informed so we can provide the very best care and to make sure your pet has an enjoyable experience with us. Fields marked with an * are required and the form cannot be completed without a response.

 


Complete the form and print it and then deliver by hand, fax or mail to:

6429 Transit Rd.
East Amherst, NY 14052
Fax: (716) 741-4538


(The print button is located at the bottom of the page)

Owner Name *
Pet's Name * Breed *
 
Birthday *
   
Age * Color *
 
Gender *Male Female
Spayed / Neutered *Yes No
Ownership *
How long have you owned and how did you acquire your pet?
Vaccinations *
Please check the field for confirmation.
Confirm vaccinations for Rabies, DHPP & Bortadella. (Documents must be provided prior to being your pet being admitted)
Flea
Flea & Tick Treatment *
What brand of flea and tick control do you use? When was last application?
Micro Chip *Yes No
Location of Microchip
If yes, please provide details.
Tattoo *Yes No
Location of Tattoo
If yes, please provide details
Potty Trained *Yes No
Frequency *
How often does your pet need to go to the potty?
Crate Trained *Yes No
If yes, you may bring the crate so your pet has a sense of home.
Meals *Yes No
Will meals be required.
If yes, please realize you will be responsible to provide meals each day for your pet and inform us of the quantities to be served at each meal.
Brand of Food
What brand of dog food do you feed your pet?
How Often Fed * Treats *
 
What is the feeding schedule? Are treats allowed?
Special Diet
Describe any special diet your pet requires.
Health *Yes No
Does your dog have health issues.
Medical Issues / Health Concerns
If yes, describe any serious medical conditions or previous surgeries. Also detail any restrictions to physical activities.
Medications
List any medications and reasons for use.
If medication is required while at Cara Mia, bring it with the original prescription bottle and instructions for staff to administer properly.
BEHAVIOUR
General Temperament *
What is the over all temperament of your pet?
Energy Level *
1 2 3 4 5
Please indicate which energy level best describes your pet. (1 = Couch Potato, 5 = Never Stops Moving)
Describe your pet. (check all that apply) *
Mellow Shy Energetic Pushy Friendly Timid Confident Obsessive Fearful Active Obedient Submissive Couch Potato Excitable Dominant Playful Laid Back Agressive Destructive
List of Commands
Please enter the list of commands that your pet knows.
Describe Additional Behaviours
Is there anything else we should know about your pets characteristics?
Behaviour issues
Please tells us if there is any part of the body that your pet does not like touched our handled. Also tells us about anything that causes your pet to become scared, agitated, anxious or fearful.
Leash *
Describe how your pet walks on a leash.
Escaping *Yes No
Has your pet ever escaped or attempted to escape by digging, jumping or climbing?
Circumstances
If yes, please describe.
Confrontation *Yes No
Has your pet had confrontations with other pets or strangers?
Indicators
If yes, please provide details and the indicators to the behaviour.
How does your pet respond to the following:
Male Dogs *
Female Dogs *
Puppies *
Bigger Dogs *
Smaller Dogs *
Cats *
Adults *
Children *
Has your dog ever bitten anyone? *Yes No
If yes, describe.
How does your pet share:
Food/Water *
Toys *
Possessions *
How does your pet respond to:
Baths *
Nail Trimming *
Favorite Activites
Ball Frisbee Cuddling Keep Away Tug Belly Rubs Brushing Massage Solo Play TV
Check any that apply.
Other Activities
Describe any other activities your pet enjoys or any other additional information you think we should know to care for your pet.
Signature * Date *
Please print this form and mail or bring it to the address indicated.
Print this page Print This Form