Questionnaire | A TrustedFriend

Owners First and Last Name:

Arrival Date

Owners Contact Phone Number

Departure Date

Pets Name(s) & Breed

Pet's Year of Birth

Is your pet spayed or neutered?

Neutered

Spayed

Neither

What services are you looking for?

Grooming

Boarding

Is your K-9/Feline/Exotic pet's up to date on their vaccines? A Trusted Friend is not liable for illness incurred during my pet's stay if proof is not shown.

Rabies

Bordetella

Please list any medications your pet is currently taking. If scheduled for boarding, please including the dosage, and frequency:

Is your pet fully potty-trained, including in new environments (no marking or accidents)?

No

Yes

Would you like a go-home bath during their boarding stay? ($35-$60) *Please select no for grooming appointments

No

Yes

Does your pet get along with other animals, Big or Small? (other dogs)

No

Yes

Please explain:

Does your pet attempt to jump fences or dig to escape?

No

Yes

Does your pet respect kittens or cats?

No

Yes

Does your pet have any congenital birth defects, or physical limitations?

As needed, do you provide flea, tick, or heartworm prevention for your pet?

Does your pet have any environmental, or dietary allergies? If desired, may they have Peanut Butter, Whip Cream or Hypoallergenic Treats, during their visit?

Does your pet have any triggering anxieties to be aware of? Is there any history of a poor grooming experience?

Emergency Contact Info

Please provide the best phone number to contact with concerns!

Would you like a backup contact on file? (Name & Number)

In case of an emergency

Do you authorize any injuries that require veterinary care to be covered by A Trusted Friend? (Pre-existing conditions are excluded)

No

Yes

Our Trusted Pet Hospitals:

General Practice Hospital: Parkville Heights Animal Hospital

Emergency Hospital: Kansas City Animal Emergency

I declare that the info I've provided is accurate & complete.

Initials

I would love to learn more about your special furry friend!