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Pre-Boarding Information

You must complete a Pre-Board Information form before you can board your dog.  You can print this blank form and fill it out or you can fill it out online with a valid email address and then click the SUBMIT button to send it to Karen's Canines.  Thank you!

Boarding Information
Boarding Dates:   Dates Confirmed with Karen? YES    NO

Pet Information
Dog's Name:   Gender: Male  Female
Neutered/Spayed: Yes  No   Dog's Age:
Breed:   Description:
Vet's Name:   Vet's Number:

Owner Information
Owners Name: Address:
City, State, ZIP   Home Number:
Work Number: Cell Number:
Your email Address: Vacation Number, if possible:

Emergency Contact
Emergency Name: Emergency Home Number:
Relation to You: Emergency Work Number:
Emergency Cell Number:    
       
   
Question Answer Explain or describe if necessary
Does your pet react to storms? Yes  No
Is your pet a fence climber? Yes  No
Any significant allergies? Yes  No
Recent internal or external parasites? Yes  No
Handicaps (Trouble walking, etc.)? Yes  No
Eye, ear or skin problems? Yes  No
Problems breathing, coughing or choking? Yes  No
Any recent surgeries?  Yes  No
Tumors or lumps? Yes  No
Personal habits or traits? Yes  No
Recent changes in diet, appetite, water consumption? Yes  No
Recent vomiting, diarrhea, constipation or trouble urinating? Yes  No
Recent behavior, mood or attitude change? Yes  No
Has your pet ever bitten or attacked without provocation? Yes  No
Any recent exposure to insecticides or toxic chemicals? Yes  No
Any other comments or instructions:

Be sure to click the SUBMIT FORM button to send the form.  You will receive a confirmation page containing your input upon completion.  You can print the confirmation.

Thank you for visiting karenscanines.com. 
4110 Kane Rd.  Carleton, MI  48117  734-654-6258
email Karen: canine@dundee.net
webmaster: schroederwallace at verizon dot net