Choose the service you’d like to book
Full Name
*
Nombre
Apellido
ID Number
*
Phone Number
*
Email
*
Registration Date
*
Date on which this form is being completed :) (DAY/MONTH/YEAR)
MM
DD
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Please provide an emergency contact (Name, phone, email, relationship)
*
Clinic Name
*
Veterinarian’s Name
Phone Number
*
Address
Does your veterinarian provide 24/7 emergency service?
*
In the event of an emergency, do you authorize Hotel ROOF to contact your veterinarian?
*
If we are unable to reach your veterinarian, do you authorize Hotel ROOF to contact another veterinary clinic?
*
Pet’s Name
*
Date of Birth
*
DAY / MONTH / YEAR
MM
DD
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Breed
*
Sex
*
Weight
*
Distinctive Marks (birthmarks, tattoos, microchips, etc.)
Please indicate your pet’s usual behavior with people and/or other pets.
*
Additional comments about your pet’s behavior and temperament towards people or other pets
Does your pet suffer from separation anxiety or nervousness?
*
Fears of: fireworks, thunder, lightning, etc.
Is your pet spayed/neutered?
*
DAY / MONTH / YEAR
Date or year of neuter
MM
DD
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Does your pet suffer from allergies and/or intolerances?
*
Can your dog eat treats?
*
Additional comments about your pet’s diet/treats:
Has your pet had Ehrlichia?
*
If is yes, provide details and date:
Does your pet have skin, ear, or eye problems?
*
Pre-existing, non-contagious conditions
*
Does your pet take any medication?
Would you like to receive an electronic invoice?
*
Name or Business Name
Identification Number
Type of Identification
ID
Passport
DIMEX
Phone Number
Email
Economic Activity Code
Address
How did you hear about us?
If referred, please indicate the name of the person:
Terms & Conditions
*
