Name:

CONTACT information

OWNERS INFORMATION
PETS information

Name:
Gender:

DOG HEALTH
RECORDS
Address:
City STATE
Home Phone:
Cell Phone: ( )
Work Phone: ( )


VETERINARIANS INFORMATION


Name:
Address:
City STATE
Phone: ( )


EMERGENCY CONTACT INFORMATION

Name:
Relationship:
Phone: ( )
Emergency #: ( )

o Spayed o Neutered
Breed:
Date of Birth:
Height: Weight:
Registration#:
Registered Name:
Sires Reg. #:
Sires Name:
Sires Breed:
Dames Reg. #:
Dames Name:
Dames Breed:

PETS IDENTIFICATION

Microchip ID Number:
License Number:
Collar Color:
Identifying Markings:
Keeping track of your pets health











Congratulations on your new puppy from.



GROOMERS INFORMATION
SPECIAL MEDICAL INFORMATION

Diet:

Name:
Name:

Phone: ( )
Collar Size:
Last Shampoo:
Last Bath:
Comments:
__________________________________________________


Allergies:




Medical Conditions:
Date of Birth:
Breed:
Sex:
Markings:
Veterinarian:

__________________________________________________



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P
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f
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z
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R
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s

L
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p
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B
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r
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L
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D
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VACCINATION history

FECAL/DEWORMING



Date Results

_______ _____________________________________
MEDICAL notes


Date Results

_______ _____________________________________


Age Date
wks o
wks
o

wks o
wks o
wks o
1 year
o

2 years
o

3 years
o

4 years
o

5 years
o

6 years
o

7 years o
o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ __________________________________

_______ __________________________________

_______ __________________________________

_______ _____________________________________


HEARTWORM history
_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ __________________________________

_______ __________________________________

_______ __________________________________

_______ __________________________________

_______ __________________________________

_______ _____________________________________
8 years
o

9 years
o

10 years
o

11 years
o

12 years
o

13 years
o

14 years
o

15 years
o

16 years
o

o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o
o o o o

2 - 5 Weeks
First deworming
at 2 weeks
Second deworming



6 - 12 Weeks
at 6 weeks
at 8 weeks
Fifth deworming
at 10 weeks
Sixth deworming
at 12 weeks

Date







Date

Vaccination







Vaccination
_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ ___________________________________

_______ __________________________________

_______ __________________________________