Name:
Phone:
-
Address:
Your Email:
Veterinarian Info:
Emergency Contacts name & numbers:
Dogs Name:
Primary Breed:
Spayed/Neutered?
How long have you had your dog?
Did your dog come from a rescue or breeder?
Will you be bringing your own dog’s food?
If You will bring your own pet food please specify the Brand:
If you would like for your dog to receive our house food, please initial here:
How many times per day would you like your dog fed?
Feeding Times:
Has your dog ever growled or snapped when taking food or toys away?
Has your dog ever shared his/her food with other animals?
Has your dog ever eaten his/her own feces?
Any other information we should know about your dog’s eating and food habits?
Is your dog currently on a flea and tick preventative ?
Is your dog allergic to any type of food?
If yes, please describe allergy and the reaction:
Is your dog allergic to any medications?
Is your dog currently taking any medi cation?
If yes, please list the medication and describe the reaction:
Does your dog have any current or old injuries or health concerns?
If yes, please describe:
Has your dog been in good health for the last 30 days?
Is your dog house trained?
Has your dog had any obedience training?
Check all answers that describe your dog’s personality: (check all that apply)
Describe your dog’s activity level:
What commands does your dog know?
Has your dog ever jumped over a fence?
At feeding times, your dog eats:
Have you ever boarded your dog before?
Have you ever taken your dog to daycare before?
Check all situation where your dog may become unfriendly or agitated:
Has your dog ever bitten anyone?
If YES, please describe:
Has your dog ever bitten another dog?
If YES, Please provide information:
How does your dog react when strangers approach?
Does your dog respond negatively to any certain type of person? (i.e. men with beards, children)
If YES, Please describe:
Does y our dog have separation anxiety?
Are there any other issues you wish to inform us about your dog’s behavior?
If YES, Please Explain:
Does your dog prefer to play with:
Are there any breeds your Dogs do not prefer?
Additional Information / Special Instructions*