STC Reservation Request Your name First Last Email* Name of dog(s)* DATE OF DROP OFF* MM slash DD slash YYYY TIME OF DROP OFF* NOON - 1 PM 7 PM - 8 PM DATE OF PICK UP* MM slash DD slash YYYY TIME OF PICK UP* NOON - 1 PM 7 PM - 8 PM Emergency contact person during this trip* First Last This is a person who would be available to pick up your dog if there is a medical emergency and take to the Vet.Cell phone number of Emergency contact person.*FEEDING INSTRUCTIONS (please enter quantities)MEDICATION INSTRUCTIONSComments for this stayPLEASE NOTE: House with a Heart reserves the right to turn away any dog that is in poor condition at the time of drop off. This includes: Dogs who are in obvious pain, have not been seen by a Vet and do not have medication to keep them comfortable. Dogs who are matted and dirty and in need of grooming.* I agree I disagree Δ
