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Otis & Louie Ltd - 64 Northland Road, Kelburn/Northland, Wellington, 6012, New Zealand
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04 475 7736 |
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| 64 Northland Road, Wellington 6012
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Home
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Dog Daycare
> Daycare & Pet Grooming Application Form
Daycare & Pet Grooming Application Form
Please send us your details below and we will make contact re your enquiry!:
Client Details
Client First Name*
Client Surname
Client Street No & Street Name
Suburb
City
** Hint - Wellington, Lower Hutt, Porrirua, Kapiti Coast
Postcode*
* We need your Postcode
Client Email Address*
Mobile Number:*
Landline Number*
Please supply Prefix if applicable eg 04 1234567
Work Number*
Partner/Spouse Name of Significant Other*
Emergency Contact Number:
Your Pets Information
Pet's Name:*
Pet's Sex
Choose?
Female
Male
Pet Breed:*
Pet Date of Birth:
Pet Weight
1 - 5kg
6 - 10 kg
11 - 15kg
16 - 20kg
21 - 25kg
26kg and over
Vet Name
** Hint If it's a franchise let us know which branch you use
Are VAX up to date?
Choose?
Yes
No
Neutered/Spayed:
Choose?
Yes
No
Microchip? Y or N
Choose?
Yes
No
Is Pet on Medication?
Choose?
Yes
No
Is you pet Deaf?
Choose?
Yes
No
Is your pet Vision impaired?
Choose?
Yes
No
Blind in one eye, Blind, Cataracs etc
Are there any Mobility Issues?
Choose?
Yes
No
Recent Surgery we need to be aware of?
Choose?
Yes
No
Administration Information
Have you registered your pet? Wellington City Council? Or Other?
Yes
No
Puppy School and/or Training?
Choose
Yes
No
Looking for a trainer!
Do you offer puppy training?
Has your pet been groomed before? When and Where?
Otis & Louie are not liable for any injuries to your pet in our care. Please advise if you have Pet Insurance. Y or N
Choose!
Yes, I have pet insurance.
No, I do not have pet insurance.
I'm not sure where I would get Pet Insurance!
Our policy upon coming to our Business Premises - All pets with leads/crates at all times.
Please advise
Yes, I understand.
I don't have a cat crate.
I have a Service Dog and need drop off assistance!
Do you Require Special Assistance?
Choose From The Following Options
No. No assistance required.
I have a Service Dog and require pick up.
I will need assistance dropping and picking up
My dog has health issues
Specific Question?
* Put any additional queries you may have on our services.
Last Step
Please type the characters you see and then press the SEND button
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