ABOUT YOU

Owners name:___________________________________

Address:____________________________City____________State________Zip__________

Phone:_______________Work:______________Cell:_____________________

Email address:_______________________________

Emergency contact name/phone:__________________________________________________

Emergency Delegate (if different from above)________________________________________ (this is the person you authorize to make decisions during boarding in the event you cant be contacted).

Your Vet:__________________________________phone______________________

ABOUT YOUR DOG- DAYCARE

Dog’s name:_________________Breed:__________________Color:_________________

DOB/AGE :___________Sex: Male____ Female____ Approx. weight_____________

Is your pet Spayed or Neutered: _________________________________

How did you acquire your pet?_________________ at what age?_____________________

Does your pet have any of the following tendencies?

Escape _______Evade_________ Nipping or biting__________ toy protection________

Excessive Barking ________________ reluctance to obey your commands____________

Does your pet undergone any recent medical procedures or been treated by a vet in the past 90 days?__________Explain_________________________________________________

Is your pet taking any medications?___________________________________________

Is your pet on a special diet or is treat restricted?______________________________

ABOUT YOUR DOG- BOARDING

What is your dog’s current food type and amount?_______________________________

What is your dog’s favorite treat and toy?___________________________________________

In the event your pet becomes dirty during his stay, may we bath him?___________________

Has your dog ever bitten anyone?___________________________________________

Has your dog ever been in any fight with another dog?___________________________

Is your dog afraid of any type or size of dogs?_________________________________

Is your dog sensitive to being touched anywhere?________________________________

Are there any other issues you would like us to observe and/or work on with you? _____________________________________________________________________

Has your dog ever boarded?_________________________________________________

Been to a Dog Daycare?__________ Why did you stop?_____________________________

Is there anything else we should know about your pet? _________________________________________________________________

Facility use:

Shot record verification_________________________________date_________________

Personality profile___________________________________

Dominance lean_______________________________________

Stranger reaction___________________________________

Dog reaction______________________________

Playgroup suggestions______________________

Activity suggestions__________________________________________________