Reservation Request

* required field

Owner's Name *

Pet's Name *

Email *

Confirm Email *

Phone Number * xxx-xxx-xxxx

Arrival *

Departure *

Housing Request: *

Requested Activities

Daycare:

Pal Time:

Playtime:

Nature Walk:

Lazy River Swim:

Treadmill:

Additional Potty Break*: *3 potty breaks per day are standard

Room Service

Room Service Selections:

How Often:

Pampered Services

Professional Bath:

Yes No

Grooming (Haircut):

Yes No

Nail Trim:

Yes No

Nail Rounding:

Yes No

Massage Therapy:

Rememberance Vacation Photo Album:

Yes No

Feeding Schedule

Feeding:

How Often:

Comments:

Medication Schedule

Medication:

Yes No

Medication Number 1 Name of medication:

How Given: Frequency?: If Other, Specify:

Special Instructions:

Medication Number 2 Name of medication:

How Given: Frequency?: If Other, Specify:

Special Instructions:

Medication Number 3 Name of medication:

How Given: Frequency?: If Other, Specify:

Special Instructions:

Medication Number 4 Name of medication:

How Given: Frequency?: If Other, Specify:

Special Instructions:

Paws By The Lake • 33757 Lake Road • Corner of Lake Road & Miller Road • Avon Lake, Ohio 44012 • 440.933.5297
Monday through Friday 7:00 a.m. - 7:00 p.m. • Saturday 8:00 a.m. - 4:00 p.m. • Sunday Noon - 2:00 p.m.
© 2010 Avon Lake Animal Clinic. All rights reserved.

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