Dear Dog-owner,
please, try to answer all questions as best as you can. The info you provide us
with is very important
to help us take proper care for your dog.
Thank you!
Dog's name:
Breed:
Gender: F
M
Altered? Yes
No
Birth Date:
AKC registration number:
Tattoo or microchip #
Microchip
registry:
Veterinarian, address, phone#:
Date of most recent inoculations:
Please, attach vaccination records
and rabies certificate!
Rabies
DHLPP
Corona
Bordatella
Other
Heartworm Preventative?
Yes
No
If, yes, which day of the month?
Any medical conditions we should
know about?
Any medications we must
administer?
If your dog is a female, when was her
last season?
(Please, note: We might send
females who come into season while with us home)
Is your dog: House-trained?
Yes
No
Crate-trained?
Yes
No
What does your dog like best?
What does your dog dislike?
What does your dog Fear?
Any particular bad habits?
Has your dog ever shown aggression toward a person?
Yes
No
If,
yes, please, explain
Has your dog ever shown aggression toward another dog?
Yes
No
If,
yes, please, explain
Where does your dog usually sleep?
Where and how does it spend the day?
Briefly describe your dog's daily
schedule:
List commands, words your dog is
familiar with:
Please, describe any previous
training your dog has had:
Please, add any additional information about your dog that may be important
for us to know:
Please, explain your expectations
of your dog's accomplishments while with us:
Owner's Name:
Emergency Contact:
Name:
Address:
Phone- Home:
Work:
Phone numbers:
Cell:
Email:
Please, bring this completed form, and
medical records with you, when you bring your dog, Thank you!