Health Declaration

Please fill out the following form.

First and Last name

Pets name and Age

Phone number

Email

Veterinarian Name

Veterinarian Phone Number

Birthday or Adopt Day

Dog is over the age of 6 months

Is your pet on any heartworm prevention, flea & tick prevention, or any other medications?

Any Injuries or Medical Conditions we should be aware of?

Yes

No

Any history of seizures?

Yes

No

Please Inform K9 Cardio Fitness of any Medical Conditions, Allergies, or important information we may need to know.

I give K9 Cardio Fitness consent to use any pictures or videos of my pet or myself for use on their website, social media, and/or advertising.

Yes

No

I understand any pictures and/or video produced by K9 Cardio Fitness is the sole property of K9 Cardio Fitness.

My dog's nails are properly groomed and do not excessively drag on the ground.

I have consulted with a veterinarian and have been cleared for this activity.

I agree to all policies, procedures, and terms of agreement.

I declare that the info I’ve provided is accurate and complete.

Initials