TRANSPORT REQUEST FORM

NEW CLIENTS ‣ Please complete this form to help me learn about you and your pet. This will help me create a quote for you.

ESTABLISHED CLIENTS ‣ You can email me your upcoming transport dates.

For more info on pet transport requirements, visit the Pet Transport page.

Transport Request Form

Your Name *

First

Last

Your Email Address *

Email

Confirm Email

Departure Address (City & State): *

Departure Date (or Date Range): *

Flexibility with transport dates is appreciated.

Arrival Address (City & State): *

Arrival Date (or Date Range): *

Flexibility with transport dates is appreciated.

DEPARTURE DETAILS · Sender's Name: *

First

Last

Sender's Phone Number: *

Sender's Email Address:

Sender's relationship to pet: *

• Owner
• Breeder
• Trainer
• Foster Parent
• Shelter
• Rescue
• Family of Owner
• Friend of Owner
• Other:

Check all that apply. If "Other" please describe below.

ARRIVAL DETAILS · Receiver's Name: *

First

Last

Receiver's Phone Number: *

Receiver's Email Address:

Receiver's relationship to pet: *

• Owner
• Breeder
• Trainer
• Foster Parent
• Shelter
• Rescue
• Family of Owner
• Friend of Owner
• Other:

Check all that apply. If "Other" please describe below.

Pet's Name *

Please complete a separate form for each pet.

Age or DOB *

Breed(s) *

Dog Weight (lbs) *

Dog Length (inches) *

From tip of nose to base of tail while standing

Dog Height (inches) *

From top of head to floor while sitting

Sex *

• Male
• Female

S/N Status *

• Neutered/Spayed
• Intact
• Pregnant
• Nursing

Date of last flea preventative? *

Date of last rabies vaccination? *

Date of last distemper-parvo vaccination? *

Date of last bordatella (kennel cough) vaccination? *

After booking, can proof of vaccinations be sent via email to KHC? *

• Yes
• No
• Unsure

Will the pet be changing ownership during transport? *

• Yes
• No
• Unsure

If the pet is changing ownership, will they have a health certificate or CVI? *

• Yes
• No
• Unsure
• N/A

How is your pet with new people? *

• Friendly
• Cautious
• Aloof
• Aggressive
• Guards Food or Water Bowl
• Guards Crate or Bed
• Guards Toys or Balls
• Guards Kongs or Chews
• None
• Unknown

Please check all that apply

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Is your pet comfortable with being lifted into a vehicle? *

• Yes
• Yes, but wiggly
• No
• No, needs ramp
• Unknown
• Other:

Please check all that apply

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How does your pet behave in the car? *

• Never ridden in vehicle
• Never been crated
• Calm in crate
• Anxious in crate
• Sleeps/rests
• Paces
• Barks
• Vomits
• Whines
• Urinates
• Defecates
• Lunges at passing cars
• Lunges at passing people
• Unknown

Please check all that apply.

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How is your pet around new dogs? (i.e. when crated or on-leash) *

• Friendly
• Barks
• Wants to play
• Cautious
• Aloof
• Aggressive
• Guards Food or Water Bowl
• Guards Crate or Bed
• Lunges
• Growls
• None
• Unknown

Please check all that apply

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Does your pet have separation anxiety? *

• NONE — rests quietly when crated or alone in home/vehicle; may whine or bark at first but quiets quickly
• MILD — needs chew toy or other distraction in order to rest when crated or alone in home/vehicle; may whine or bark with or without distraction
• MODERATE — doesn’t rest when crated or alone in home/vehicle even with distractions; may injure themselves or damage property when alone; barks
• SEVERE — attempts to escape when crated or alone in home/vehicle; injures themselves; damages property; barks or whines without stopping

Check all that apply

Does your pet have a bite history? *

• Yes
• No
• Unknown

Are there any other traits about your pet that I should be aware of? *

• General anxiety
• Fear of loud noises
• Strong prey drive
• Chases bikes, cars, other wheels
• Bolts out of crate
• Reactivity towards people
• Reactivity towards dogs
• Redirected aggression when stressed
• Compulsive barking
• Compulsive ingestion of non-food items (pica)
• None
• Unknown

Check all that apply

Will you be sending food for your pet? *

• Yes
• No

Feeding instructions:

Will you be sending medication for your pet? *

• Yes
• No

Medication instructions

Is any of the food or medication perishable? *

• Yes
• No

Does your dog have any health issues? (i.e. deafness, seizures, ACL surgery, etc.) *

Does your dog have any allergies or food sensitivities? (i.e. no chicken treats, no peanut butter, etc.) *

Will you be sending any gear with your pet? *

• Crate
• Cage
• Bed
• Leash
• Collar
• Kibble
• No gear
• Other:

Please provide description and approximate dimensions of gear. I will do my best to accommodate! If you are sending a crate, please let me know the dimensions and material (i.e. 36" x 22" x 25" folding wire crate).

In the event of an emergency, who is authorized to make medical decisions for this pet? *

• Sender
• Receiver
• Other:

Please check all that apply. If "Other" provided their contact info below.

Anything else I should know about your pet?

PLEASE CHECK BOXES AND SIGN BELOW *

• I agree that all information provided is correct to the best of my knowledge.

• I will send my dog on transport wearing a snug-fitting flat collar or Martingale collar.

• I will send my dog on transport wearing ID tags with current contact information.

Signature *

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Date

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