All-in-One Form

(*) - Required field

Owner Information

Your Full Name
Street Address
City
State/Zip
Home Phone
E-Mail Address
Employer
Cell Phone Provider
Cell Phone
Work Phone
Cell Phone #2
Work Phone #2

Emergency Information

Name
Phone
Name
Phone

Dog Information

Dog # 1

Name
Breed
Color
Sex-Spayed/Neutered
Birthday/Age
Weight

REQUIRED VACCINATIONS:
Please attach documentation of Immunization Records for RABIES, BORDETELLA, DISTEMPER

Attach File(s):

Veterinarian Information

Clinic
Veterinarian
Phone
Address
City
State/Zip

Feeding & Health

If this is the first time your dog is staying with us or there have been changes to his/her feeding program, please fill out the following:

How often do you feed your dog?
Any food sensitivities?
Brand & amount (in cups) of dry dog food?
Brand & amount of moist food?
List any necessary medications &/or food supplements
List any treat/snack restrictions
What sort of a potty schedule is your dog on at home?

Is your dog permitted to have rawhide treats?

Is your dog on a flea preventative?

Date of last treatment?

Does your dog have any allergies?
List any current medical problems
Are there any restrictions on your dog's activities or movement?
How long has your dog owned you?
Where did you get your dog?

If adopted, do you have knowledge of your dog's past history?

If yes, please explain it

Number of people in your household?

Adult males?

Adult females?

Kids?

List the other animals in your household:

Pet Information

Pet # 1

Species/Breed
Age
Sex
Describe how your dog gets along with this pet

Does your dog have any sensitive areas on his/her body?
Does your dog like being brushed?
What is your dog's favorite petting spots?
Are there any kinds of people or animals your dog automatically fears or dislikes?
Where does your dog spend his time at home? (outside, confined to one room, run of the house, etc.)
Is or has your dog ever been crated? Under what circumstances?
How many times per week is your dog leash-walked outside?
How long are your walks?
Has your dog ever bitten anyone? What were the circumstances?

Does your dog have any problems in the following areas?

Barking?

Ignoring commands?

Housetraining?

Chewing furniture/bedding?

Digging?

Is your dog frightened by any noises?
Has your dog ever growled or snapped at anyone taking food or toys away?
Has your dog ever shared his/her food with other animals?
Does your dog play with toys? If yes, what kind?
Does your dog play with other pets? If yes, what kind?
Does your dog know any tricks? What does he/she do?
What commands does your dog know?

Does your dog have a bathroom command?

Does your dog have a play command?

Does your dog have a quiet command?

Other comments or information about your dog that you feel might be helpful?
How did you hear about The UltiMutt Inn & Pet Resort?

Read Rules, Regulations, Agreement, & Release Here

Office Hours
for
Pick-ups and Drop-Offs

Monday
to
Friday

by appointment only

8:00am - 10:00am
and
4:00pm - 7:00pm

Saturday

by appointment only

8:00am - 10:00am
and
4:00pm - 6:00pm

Sunday

by appointment only

9:00am - 10:00am
and
4:00pm - 7:00pm

Contact

E-Mail Address
Comments or Questions

13501 Butternut Road
Burton, OH 44021