Pet Monitoring Checklist
Complete this checklist to record the care and well-being of your pet during each monitoring period.
Date and Time of Check
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Pet's Name
*
Species/Breed
*
Your Name (Observer)
*
First Name
Last Name
Feeding Status
*
Fed as scheduled
Partially fed
Not fed
Water Status
*
Fresh water provided
Water bowl checked and refilled
No water available
Exercise/Play
*
Adequate exercise/playtime given
Limited exercise/playtime
No exercise/playtime
Cleanliness Check (litter box, bedding, etc.)
*
Clean and sanitary
Needs cleaning
Unclean/soiled
Health & Behavior Observations
Normal behavior
Eating/drinking well
Signs of illness (vomiting, diarrhea, coughing, etc.)
Unusual behavior (lethargy, aggression, hiding, etc.)
Other (please specify)
Medication Given?
*
Yes
No
Not applicable
Notes or Concerns
Submit Checklist
Should be Empty: