New Team Member Form

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New Member

You may add additional pets on the next screen

* Indicates required field

Parent Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Pet #1 Name *

First

Last

Pet's Age *

Species/Breed *

Vet Clinic *

MEDICAL

How is your pet's VISION? *

How is your pet's HEARING *

How is your pet's DIGESTION? *

Is your pet currently on any medication? *

List Medications Here: *

Does your pet have any medical concerns? *

Cancer/ Illness Seizures/ Heart Murmur Arthritis/ Injuries Skin/ Ear Infections Dental Isuues Allergies NONE

choose all that apply

Detail Medical Concerns Here: *

BEHAVIOR

How is your pet with PEOPLE? *

How's your pet with ANIMALS? *

How is your pet while you're away? *

Does your pet have any behavioral concerns? *

Protective/Aggression Reactive/Anxious Shy/Nervous Sesitive to touch/sounds Other NONE

Detail Behavior Concerns Here: *

Feeding

How often does your pet eat? *

AM Noon PM Free feed

choose all that apply

Serving size per meal *

Can your pet have treats? *

Yes, only ours Yes, any treats No treats

additional feeding instructions: *

Is your pet spayed / neutured? *

Questions or Comments: *

Do you agree to Duke Dog Care's terms? *

Yes. I read and agree.

Join the Team!

"Your Pet's Best Friend"

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In loving memory of Duke 10/8/07 - 6/10/21