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NEW CLIENT
At Safe Haven Pet Resort, we take care to provide our customers high quality services personalized for their unique needs. We are available to take your order 24 hours a day, 7 days a week.
We have a variety of services including:
Alerts:
Owner’s Name(s) _______________________________________________________________________________
Address:_______________________________________________________________________________________
City: _____________________________ State: _________________________Zip Code: ______________________
Home #:__________________________________________ Work #: ______________________________________
Cell #1: ___________________________________________Cell #2: ______________________________________
Cell phone provider: Verizon / Alltel / Other:_________________ Are you able to receive text messages? Yes | No
E-Mail: ________________________________@___________________________________________
** Your information will NEVER be shared – we only use it for Safe Haven purposes only!
We will only use this information to send out reminders of appointments, send pictures of your loved ones while you're away etc..
Vaccination Requirements: DOGS: DHLLP , Rabies, Bordatella (required every 6 months)
PET INFO:
Name:________________________ Breed:__________ Color:_________ DOB:________ Spayed/Neutered: Y| N
Name:________________________ Breed:__________ Color:_________ DOB:________ Spayed/Neutered: Y| N
Name:________________________ Breed:__________ Color:_________ DOB:________ Spayed/Neutered: Y| N
Veterinarian: ________________________________________________________________________
Emergency Contact Information: (someone other than yourself OR Veterinarian)
Name: ________________________ Relationship: _________________ Phone #: __________________
Please list ALL family members and/or friends that have permission to visit and/or pick up your pets.
Name__________________________________________________Phone #:________________________
Name__________________________________________________Phone #:________________________
How did you hear about us?
□ Drive By □ Internet□ Friend…. Referred by? ___________________________We’d like to thank them! □ Veterinarian Clinic…. Name of Clinic: ________________We’d like to thank them!□ Phone Book Circle one (Gold Pages | Yellow Book | Dex) □ Other: please explain:______________________________________________________________Signature_______________________________________________Date___________________
