A Pawsitive Experience requires a Health
Exam, vaccines and indicated fecal testing before assessment.Exam must be within
30 days of first appearance - no less than 10 days.Have your Vet fill in EACH
line of the the form completely & INITIAL EACH LINE.Fax copy
and return ORIGINAL to A Pawsitive Experience.
CERTIFICATE MUST BE EXECUTED
IN FULLBEFORE DOG IS ALLOWED ON PROPERTY
(Insert Vet Stamp
with Name and Address to your right )
Owner:
Dog:
Address:
Breed/Sex:
City:
Birth Date & Age Now:
Phone:
Color:
*** Vaccinations & Misc. ***
DATE
GIVEN
VETINITIALS*
NOTES
DAP (per vet recommendation)
RABIES (per state rqmts)
CANINE COUGH (Annual)
OTHER (Flea Check & Nails Clipped (mandatory)
*Vet Note: Vaccines at your discretion.
Indicate Titer results, vaccines given/withheld and why.Vet’s initial
required in each space.
*** Parasite &
Bacteria Testing***
Mandatory for Attendance - Annually
Thereafter)
DATE TESTED
VETINITIALS
RESULTS, NOTES & RX
Parasites & Coccidia
Giardia (SNAP or ELISA TEST only accepted)
*** Optional per Client
& Vet Discussion ***
DATE TESTED
VETINITIALS
RESULTS, NOTES & RX
Heartworm Test (8 months & older) Initial Test Annually thereafter if not
on monthly March thru November
LEPTO Vaccine (only if high risk and vet recommended)
CANINE FLU (Vaccinate @ vet and client option)
*** Vet Certification ***
I certify that (1) I have (within
the last 30 days) examined and tested this patient as indicated above and: found them to be in good health, free of signs
of infectious diseases, parasites including but not limited to fleas, lice, diarrhea, coughing, nasal drip or conjunctivitis
on this date AND/OR (2) This is a special needs dog requiring the following:
_____________________
6440 Schultz Road, Lake
View, NY 14085(716) 627.9234 msgsFax 627.1330 k9taxi@earthlink.net
6440 Schultz
Road, Lake View, NY 14085(716) 627.9234 msgsFax 627.1330
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All material and reference to any and all of this
web site whether in part or entirety, including the name or any part thereof, A Pawsitive Experience (TM), is the property
of owner herein and cannot be used in part or whole without express written consent. A Pawsitive Experience (TM) is the original dog daycare by this name. Our goal is to
create "A Pawsitive Experience" and provide
support for all services offered.