New Client Registration Form

K9 Nation La | New Client Registration Form

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

K9 Nation La New Client Registration Form

Please complete the forms below to your fullest extent. We will contact you if additional information is required.

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

DOB

Vaccine Expiration Dates

K9 Nation La requires proof of vaccination.

Rabies

DPP

Bordetella

Vaccine #4

Vaccine #5

Microchip Code

Weight

Insurance Info

Feeding Notes (What food, how much, when, any special diet needs, etc.)

Medication Notes (Name, dosage, frequency, special instructions, etc.)

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

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

Mobile Phone Alert: Some phones have difficulty uploading the files below (the form gets reset after uploading). If this happens on your phone, please submit this form using a computer. You can also submit this form on your phone without uploading anything and then email your pet picture and vaccine verification document to us at thek9nationla@gmail.com. Thanks!

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

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