New Client Registration Form | Petite Urban Pooch

The form below is for new clients only. If you're already a client of Petite Urban Pooch, please click here to request an appointment.

Petite Urban Pooch New Client Registration Form

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Thank you for choosing PUP for your pooches social and exercise playdates! Please complete the registration form with as much detail as you have available. The link below takes you to our waiver form which you can print off and sign to bring with you on your trial visit! We look forward to meeting you and your pooch..

Important: In addition to the online form below, please print the following PDF document and bring it to your first appointment: Click to Print

Petite Urban Pooch Client Registration Form

Owner Information

First Name *Required*

Last Name *Required*

Phone Number *Required*

Email *Required*

Address

City

State | Province

Zip Code | Postal Code

Family Vet Clinic

How did you find us?

Emergency Contact (Include Phone Number)/Others Allowed to Pick Up

Pet #1 Information

Pet Name *Required*

Breed (Best Guess) *Required*

Sex *Required*

Color Description

Date of Birth

Petite Urban Pooch requires proof of vaccination.

Rabies Expiration

DPP Expiration

Bordetella Expiration

Canine Cough Expiration

Flea & Tick Expiration

Microchip Code

Weight

Insurance Info

Feeding Notes

Medication Notes

Temperament Notes (Aggression, anxiety, etc? If extensive, tell us in person).

Additional Notes (Anything else we should know? If extensive, tell us in person.)

Pet Photo (Not Required. 5MB Max. Image Files Only) Click to Upload Pet Picture

Proof of Vaccinations (5MB Max. Only Images, No PDFs. Take a Picture of Document with Your Phone and Upload It.) Click to Upload a Picture of Proof of Vaccinations

Click Here to Add a Second Pet

Pet #2 Information

Pet Name *Required*

Breed (Best Guess) *Required*

Sex *Required*

Color Description

Date of Birth

Petite Urban Pooch requires proof of vaccination.

Rabies Expiration

DPP Expiration

Bordetella Expiration

Canine Cough Expiration

Flea & Tick Expiration

Microchip Code

Weight

Insurance Info

Feeding Notes

Medication Notes

Temperament Notes (Aggression, anxiety, etc? If extensive, tell us in person).

Additional Notes (Anything else we should know? If extensive, tell us in person.)

Pet Photo (Not Required. 5MB Max. Image Files Only) Click to Upload Pet Picture

Proof of Vaccinations (5MB Max. Only Images, No PDFs. Take a Picture of Document with Your Phone and Upload It.) Click to Upload a Picture of Proof of Vaccinations

Click Here to Add a Third Pet

ALERT: If you have more than three pets, submit this form once with your first three pets. After submitting the first time, click the link to come back to the form (shown after you submit the form) and fill out this form again with the information for your other pets. The second time you fill it out, you only need to include your name, phone and email in the OWNER section because the business will already have the other info (address, emergency contact, etc) from the first time you submitted the form.

Pet #3 Information

Pet Name *Required*

Breed (Best Guess) *Required*

Sex *Required*

Color Description

Date of Birth

Petite Urban Pooch requires proof of vaccination.

Rabies Expiration

DPP Expiration

Bordetella Expiration

Canine Cough Expiration

Flea & Tick Expiration

Microchip Code

Weight

Insurance Info

Feeding Notes

Medication Notes

Temperament Notes (Aggression, anxiety, etc? If extensive, tell us in person).

Additional Notes (Anything else we should know? If extensive, tell us in person.)

Pet Photo (Not Required. 5MB Max. Image Files Only) Click to Upload Pet Picture

Proof of Vaccinations (5MB Max. Only Images, No PDFs. Take a Picture of Document with Your Phone and Upload It.) Click to Upload a Picture of Proof of Vaccinations

Appointments & Bookings: If you want to request an appointment or booking with this business, click here to add those details.

REQUIRED: To prove you're not a SPAM robot, what does 2+2 equal?

If the form does not submit, please scroll up and make sure all required pet and owner fields are filled in. If the issue persists, send an email to mel.pup@icloud.com