A 501c3 Nonprofit Charity

  peration Tail Wag

Pet Care for the Military

Application for Services

Service Member Information


Name:_______________________________________________                     Date:_______________

Address:_____________________________________________                     Dates Foster Services Needed______________

Email:_______________________________________________                     ________________________________________

Phone:______________________________________text y / n

Preferred method of contact:___________________________

DOD ID#____________________________________________



Pet(s) Information


Name:_______________________________________________                      Color/markings:__________________________

Breed:_____________________________Age:______________                      Sex:___M ___ F

Health Issues:________________________________________                      Spay/Neuter:____yes ____no

Medications:_________________________________________                      Microchip:____yes ____no

Current flea prevention? ____yes ____no                                                       Current heartworm prevention?____yes ____no

Heartworm tested?____yes ____no

Up-to-Date on vaccinations?____yes ____no


Name of Veterinarian:_________________________________

Address:_____________________________________________                     Phone:___________________________________

____________________________________________________                      Pet Health Insurance?______________________



Emergency Contact Information


Name:_______________________________________________                    Relationship:_____________________________

Address:_____________________________________________                    Phone:___________________________________

_____________________________________________________                   Email:___________________________________



Name:____________________________________________                  Relationship:_____________________________

Address:__________________________________________                  Phone:___________________________________

__________________________________________________                 Email:___________________________________