registraion form| SMR Pet Services

Registration

Pet Name

Age

Breed

Veterinarian

Contact No.

Veterinarian address

Owner Name

Phone

Address

Is this animal up to date on all shots and free of contagious disease? (please explain)

Is this animal on any flea or tick prevention? (please explain)

Has this animal ever attacked and/or bitten any other animal? (please explain)

Has this animal ever attacked and/or bitten a human? (please explain)

Does the animal get along with: Dogs? (please explain)

Does the animal get along with: Cats

Does the animal get along with: Children? (please explain)

For dogs -- Has your pet ever escaped from a fenced area? (i.e., digs, jumps, climbs – does the dog need to be closely supervised in outside areas, or leashed while outside?) (please explain)

Is your pet Blind or Deaf ?

Are there particular health issues we need to be aware of?

Is your pet allowed on the furniture?

Yes

Is your pet allowed to sleep in the bed?

Yes

Is your pet spayed/neutered?

Yes

Is your pet housebroken?

Yes

Thanks for applying to volunteer with us! We'll get back to you soon.

314-750-1311

Registration

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