Client Information - Blair’s Bark & Board

Please complete the form below to provide your contact details, emergency contact, and veterinarian information. This helps us ensure the best care and safety for your dog during their stay.

"*" indicates required fields

1. Customer Information Section

Owner Name*

Date

Address*

Cell Phone*

Email Address*

How did you hear about us?*

2nd Owner Name

Cell Phone (2nd Owner)

2. Emergency Contact Information Section

Emergency Contact Name(s)*

Telephone Number(s)*

Relationship to Owner*

3. Dog Pickup Authorization

Persons Authorized to Pick Up / Drop Off Dog*

4. Veterinarian Information

Veterinarian Hospital*

Veterinarian Phone*

Veterinarian Address*