Owner Information
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| Name* |
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| Address* |
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| City, State, Zip* |
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| Home Phone |
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| Work Phone |
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| Mobile Phone |
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| Phone Number of Hotel if boarding |
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| How did you hear about us? |
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Emergency Contacts
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| Contact1 Name |
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| Contact1 Phone |
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| Contact2 Name |
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| Contact2 Phone |
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Pet Information
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| Pet Name |
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| Pet Breed |
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| Pet Sex |
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| Pet Age |
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| Pet Color |
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| Pet Weight |
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Veterinarian
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| Vet Name |
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| Vet Address |
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| Vet Phone |
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General Info
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| Dog's Name |
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| Breed |
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| Age |
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| Birthdate (if known) |
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| Sex |
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| If dog is female, is she spayed? (Male dogs over 6 months old must be nuetered prior to admission) |
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| How long have you owned your dog? |
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| Where did you get your dog? |
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| If you adopted your dog, do you know about his/her previous history? | |
| Does your dog live with: | |
| How does your dog react around children? | |
| Are there other pets n your household? How does your dog get along with them?: | |
Health & Grooming info We ask that all dogs use some sort of flea-prevention program
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| What do you use to prevent fleas/ticks on your dog? |
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| Does your dog have any allergies? |
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| Hip dysplasia/arthritis? |
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| What brand of food does your dog eat? |
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| If boarding, how much per meal & how often? | |
| Please describe any health problems or activity restrictions that we should be aware of: | |
| How does your dog react to: brushing? |
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| How does your dog react to: nail trimming? |
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| Where are your dog's favorite spots to be pet? (ie. head, tummy, etc.) | |
| Does your dog dislike petting or touching on any particular area of his body? |
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Behavior
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| If visitors bring their dogs to your home, how does your dog react? | |
| How does your dog react to a stranger coming into your home or yard? | |
| Are there any kinds of people your dog automatically fears or dislikes? | |
| Are there any kinds of dogs your dog automatically fears or dislikes? | |
| How does your dog react to puppies? | |
| What does your dog do when you are not at home? | |
| How does your dog act when you get home at the end of the day? | |
| What does your dog do to show he is happy? | |
| How often does your dog go out for walks/potty breaks each day? | |
| How does your dog react to other dogs that approach when you're out for a walk? | |
| Have you been sucessful in teaching your dog not to jump up on people? | |
| Has your dog ever growled at someone? If so, what were the circumstances? | |
| Has your dog ever bitten someone, or another dog, but not broken the skin? If so, what were the circumstances? | |
| Has your dog ever climbed or jumped over a fence? | |
| Has your dog ever bitten someone, or another dog, and broken the skin? | |
| Does your dog have any problems in the following areas? If so, please describe: Mouthiness (chewing, nipping, etc.), Housetraining, Barking, Digging, Ignoring commands | |
| Is your dog frightened by any noises? | |
| Is your dog frightened by or nervous around anything else? | |
| Has your dog ever growled/snapped at anyone, or another dog, taking food or toys away? | |
| Have you ever been unable to take items (food, bones, etc.) away from your dog? | |
| Has your dog ever shared his food or toys with other animals? | |
| What sort of toys/games does your dog like best? | |
| How often does your dog play with other dogs? | |
| Please describe your dog's behavior in a "pack" situation (dog park, playgroup, etc.) | |
| What kinds of dogs does your dog like best to play with? | |
| What kinds of games does your dog play with other dogs? How does your dog like to play with people? | |
| What commands does your dog know? (voice or hand) | |
| Does your dog have a bathroom command? | |
| Does your dog have a quiet command? | |
| If Boarding, has your dog ever been boarded before? |
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| In what type of environment (traditional kennel, cageless boarding, home of a friend, etc) ? | |
| Did your dog react in a positive/negative/neutral way to the experience? | |
| If boarding, please indicate dates you will need | |
| Please provide any other information about your dog you feel would be helpful: | |
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