Beagle BnB
Beagle BnB
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Newbies - Pet Information Form
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Admission Requirements
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Pet Information Form - Newbies
*
Indicates required field
Name of Dog
*
Birth date (dd/mm/yy)
*
Sex
*
Male
Female
Spayed/Neutered
*
Yes
No
Date spayed/neutered
*
Date of last De-worming
*
Confirm Vaccination for
*
Rabies
Distemper
Bordetella (Kennel Cough)
Please make sure to check with your VET about the Kennel Cough Inoculation. Kennel Cough is not necessarily included in the annual inoculations and sometimes need to be requested separately.
Upload copy of most up to date vaccinations
*
Max file size: 20MB
Microchip number
*
Name of Dog
*
Birth date (dd/mm/yy)
*
Sex
*
Male
Female
Spayed/Neutered
*
Yes
No
Date spayed/neutered
*
Date of last De-worming
*
Confirm Vaccination for
*
Rabies
Distemper
Bordetella (Kennel Cough)
Please make sure to check with your VET about the Kennel Cough Inoculation. Kennel Cough is not necessarily included in the annual inoculations and sometimes need to be requested separately.
Upload copy of most up to date vaccinations
*
Max file size: 20MB
Microchip number
*
Name of Dog
*
Birth date (dd/mm/yy)
*
Sex
*
Male
Female
Spayed/Neutered
*
Yes
No
Date spayed/neutered
*
Date of last De-worming
*
Confirm Vaccination for
*
Rabies
Distemper
Bordetella (Kennel Cough)
Please make sure to check with your VET about the Kennel Cough Inoculation. Kennel Cough is not necessarily included in the annual inoculations and sometimes need to be requested separately.
Upload copy of most up to date vaccinations
*
Max file size: 20MB
Microchip number
*
Temperament & Character Description(s)
*
Please provide as much information as possible. The tiniest detail is relevant. Feeding, play time, little habits and so forth. Nothing is too much. This allows us to make your hound feel more loved and welcome and at home and allows us to be aware of anything to look out for or be aware of to create as peaceful an environment as possible.
Medical Information/Food allergies or intolerances
*
If there is any medical information please describe the condition and the special treatment required. Please put the name of the dog and instructions below. List each dog individually if applicable.
Do you have Pet Insurance?
*
Yes
No
If yes - what is your Pet insurance company & insurance number?
*
Do you give the Beagle BnB (Michele Mostert/David Stone) medical proxy should we be unable to reach you?
*
Yes - please use my pet insurance number
Yes - I don't have pet insurance, I will arrange for immediate payment
No - unfortunately we cannot accept your booking
Special Requirements/Requests
*
If you have any grooming requests or special things you would like us to do feel free to put them down. We have a list of grooming options on our site.
Name of VET
*
VET's Contact Number
*
Name of Owner
*
First
Last
Cell Number
*
Email
*
Alternate Number
*
Day time delivery or PO Box address
*
Line 1
Line 2
City
State
Zip Code
Country
Emergency Contact Person (preferably not someone travelling with you. Someone you trust to make decisions on your behalf about your hound should we not be able to reach you)
*
First
Last
ECP Phone Number
*
ECP Email
*
I have signed the consent to treatment forms below (if you do not sign these we are unable to take your dog(s) )
*
Yes
Please add me to the BBnB Whatsapp group
*
Yes
No
Please add me to the BBnB mailing list
*
Yes
No
Submit
welgemoed_dierekliniek_consent_to_treatment.pdf
File Size:
464 kb
File Type:
pdf
Download File
consent_to_treatment_-_panorama_veterinary_clinic.pdf
File Size:
122 kb
File Type:
pdf
Download File