Client Questionnaire | Wingham Pet Motel

Details About You

Name*

First Last

Name Pet*

Email*

Veterinary Care

Name of Veterinary Practice

Contact Number

Address (if not Taree or Wingham)

Do you give your permission for your dog to:

Be carefully mixed with other dogs during supervised free running time?

Yes
No

Go on leashed walks outside of the kennel enclosure – inside our home and home gardens?

Yes
No

Is your pet house trained?

Yes
No

Food

What brand of food (dry and/or wet) do you feed your pet and does your pet have any dietary requirements and or food intolerances?*

If your pet is over 6 years old, has a sensitive stomach or loose stools, please bring enough food for a week or more so we can slowly transition your pet onto our food. This helps prevent gastro upsets and more serious health issues such as pancreatitis.

Is it OK to feed your pet:

Raw meaty bones
Kongs
Other puzzles

What are your pets favourite treats?

Medical

Please upload clear images showing your pets date of vaccination and due date of next vax. We do not need microchip/desexing/registration details. If we have not seen proof of vaccinations before check-in we may not be able to board your pet.

Vaccination Certificates*

Max. file size: 6 MB.

Vaccination Certificates

Max. file size: 6 MB.

Vaccination Certificates

Max. file size: 6 MB.

Does your pet have any current medical conditions?

Yes
No

Please detail medical condtions

What date was your pet last given a gastro intestinal wormer?*

What date was your pet last given a tick preventative?*

What brand of tick & flea preventative do you use for your dog?*

Meet & Greet date (in the email we sent you)*

Any other comments, requirements or information:

Emergency Contact

Two named individuals are required to be emergency contacts for your pets while boarding here. They can not be members of your household or travelling with you. These people may be contacted to assume responsibility for your pet if we cannot reach you or you are unable to collect your pet due to an emergency. They may also be asked to collect your pet in the event of a bushfire evacuation. This helps ensure your pet can always be cared for promptly and appropriately if unexpected circumstances arise. We can not accept a vet practice, it must be an individual who is willing to accept responsiblity. It can be a next of kin, a friend, or solicitor so long as you have permission from this person to act in this capacity.

Name*

Phone*

Relationship*

Emergency Contact 2

Provide contact details for someone who you nominate to collect and provide temporary care your dog in the unlikely event the Pet Motel needed to evacuate. If you are unable to provide this, you agree to permit the Pet Motel to source emergency accommodation for your pet and you agree to pay any additional fees that may be incurred for this

Name*

Phone*

Relationship*

Permissions

Would you like to see your pet on Facebook while you’re away?*

Yes
No

May we post photos of your pet on our Facebook page and use them for publicity in media such as magazines, websites and newspapers?*

Yes
No

Terms and Conditions of Boarding *

By signing this, you agree to the above terms and conditions. Thank you and we look forward to giving your pet our best possible holiday experience.*

Use your finger or mouse to sign your signature as best you can

Name

First Last

Date

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