How to use this: print this page, or use your browser’s Print dialog and choose “Save as PDF” to keep a digital copy. Fill it in from your vet’s records and keep it with your pet’s documents. This is a record-keeping form, not a legal or veterinary certificate — your vet’s signed certificate is the official document.
Pet details
Pet name
Date of birth
Breed
Sex
Colour / markings
Weight
Microchip number
Chip registered with
Owner name
Phone
Address
Veterinary practice
Practice name
Phone
Address
Emergency / out-of-hours
Vaccination record
Vaccine
Date given
Next due
Batch / lot no.
Veterinarian & clinic
Rabies
DHPP / DAPP
Leptospirosis
Bordetella
Canine influenza
Lyme
Parasite prevention
Product
Date given
Next due
Notes
Heartworm
Flea & tick
Deworming
Medical notes, allergies and medications
Known allergies
Current medications
Chronic conditions
Surgeries / procedures
Spayed / neutered
Date
One thing worth adding while you have this open: write your pet’s microchip number in the box at the top, and check that the chip is registered to your current phone number. A chip that was implanted at the vet or the shelter and never registered returns a number with no owner attached. Look up your pet’s microchip number · Register it with Peeva
