Please submit your contact and pet information below.  Your pet must have rabies, bordetella (kennel cough) and distemper as required by state and city law and for safety reasons. You will be required to submit the following Release & Authorization form with your signature.  You may either bring this in at your pet’s first appointment or sign it once at Water4Dogs. 

This is the first step in your pet’s registration. We will contact you to discuss your pet’s needs once we have reviewed this initial registration form.  If you do not hear from us within 48 hours, feel free to contact the office at 212.285.4900 x2. You may also fax in your completed registration form to 917-591-9322. For questions regarding drop off and boarding, please visit our FAQ.

PERSONAL INFORMATION

* = required field

First Name: *

Last Name: *

Mobile Phone: *

Address:

Apartment:

E-Mail: *

City:

State:

Zip Code:

Home Phone:

Business Phone:

PET INFORMATION

Pet Name: *

Age: *

Breed: *

Gender: *

Neutered/Spayed: *

Weight: *

Service Type: *

VETERINARIAN CONTACT

Hospital Name: *

Veterinarian Name:

Office Phone:

Address:

Address 2:

Veterinarian E-Mail:

City: *

State: *

Zip Code:

Specialist Name:

Specialist Phone:

Specialist E-Mail:

SUBMISSION CONFIRMATION

Submission Code: *
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Confirm Code: *