Owner Information & Medical History Form

Owner Information
First & Last Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Pet Information
Name of Pet*
Breed*
Age or Date of Birth*
Color*
Gender*
- Male
- Female
Select one below*
- Spayed
- Neutered
Has your pet suffered any trauma injury or diagnosed with orthopedic issues such as hip dysplasia, Cruciate ligament tears, Lyme disease, or disk disease?*
- Yes
- No
Is your pet taking any medication?
- Yes
- No
If yes, please explain any affirmative answers from above
Is there any part of the body that your pet objects to having touched (feet, face, tail, etc)?
Are there specific areas of concern you hope massage will help with or is there other information that is important for us to know about your pet?
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Contact Us

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Owner

Tracee Baker, Certified Practitioner

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Phone

(978) 273-2330

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Email

SpryDogMassage@comcast.net

Forms

Consent Form

Please print and have it ready for your appointment!

Owner Info and Medical History

Fill Out Form Here

NOTE:

A canine massage is not a substitute for veterinary care. If you dog has serious medical issues, veterinary approval to proceed with massage will be required.