NEW CLIENT FORM

Please submit this form for each pet you would like for alphahound to work with
I only need to fill out information on my pet (not my personal information such as address and phone numbers)
If this is the case please fill out your name (so we can identify you) and then scroll further down the page to find the section on pet's information.
Parent #1 Name *
Parent #1 Name
Parent #1 Phone
Parent #1 Phone
Parent #2 Name
Parent #2 Name
Parent #2 Phone
Parent #2 Phone
Home Address
Home Address
If residing in an apartment/condo complex please include the name of the building.
Please list the name and type (dog, cat, goats, chicken, etc.) of all household pets.
Please list the NAME and CONTACT information of any facility where your pets spend time.
Pet Information
Spayed/Neutered
Please describe what your pet looks like including color and markings.
Please list any medications your pet is on including flea, tick and heartworm prevention
Please list any known or suspected allergies your pet has.
Rabies Expiration Date *
Rabies Expiration Date
A Rabies vaccination is required for AlphaHound, Inc. services. Please have a scanned or hardcopy of your pet's records on file.
Distemper Expiration Date
Distemper Expiration Date
Recommended
Bordatella Expiration Date
Bordatella Expiration Date
Recommended
Please list the amount given at each feeding and any food preferences your pet has.
Can your pet have treats?
How does your pet do on a car ride?
Please check all applicable.
For example: Does your dog try to jump out the window? Is he/she reactive to people and sounds outside the car such as sirens or bicycles?
AlphaHound, Inc. Policies & Waiver *
By marking the box beside each statement, you indicate that you have read and are aware of each policy.
I have agreed to submit this application by electronic means. By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge. I also certify that: I understand the questions and statements in the document. I have read and understand the legal information. I understand the penalties for giving false information to breaking the rules. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.