Puppy Stay & Train Intake Form

Pet Parent #1 Phone *

(###)

###

####

Pet Parent #2 Phone Number

(###)

###

####

Emergency Contact (preferably local) *

First Name

Last Name

Emergency Contact's Phone *

(###)

###

####

Alternative Emergency Contact Phone Number

(###)

###

####

Vet Clinic's Phone Number *

(###)

###

####

I agree to cover any veterinary bills incurred and consent to my dog being treated at an emergency veterinary clinic at my cost. *

All efforts will be made to contact you and your family veterinarian prior to going to an emergency clinic. In the unlikely event that medical attention is needed immediately and your veterinarian is unable to see you dog, he/she will be taken to VMCLI or VEG Commack.

I agree and prefer VEG.

I agree and prefer VMCLI.

I agree and have no preference other than my dog's health and safety.

How does your dog most often act when crated?

Lies down and settles almost immediately

May bark/whine for 10 minutes then settles consistently

Barks/whines for longer than 10 minutes then settles

Barks/whines one and off the whole time crated

I do not crate my dog at all