Name:
Phone Number:
Address:
Email:
Emergency Contact
Name:
Phone Number:
Relationship:
Vet Name:
Vet Phone Number:
Dogs information
Dogs Name:
DOB:
Date of adoption:
Breed:
Sex: —Please choose an option— Male Female
Fully Sterilised: —Please choose an option— Yes No
Date Of Vaccination:
Where did you get your dog from?
How long have you had your dog?
Is your dog up to date with flea and worming? —Please choose an option— Yes No
What do you use?
Does your dog have any health issues: —Please choose an option— Yes No
If yes, what are they?
Is your dog on any medication? —Please choose an option— Yes No
What is it?
If yes, will we need to administer it? (we are not responsible for any injected medications): —Please choose an option— Yes No
Will your dog need any meals when with us? —Please choose an option— Yes No
Does your dog have any food allergies? —Please choose an option— Yes No
Can your dog have treats? (we use Meals for Mutts grain free sardine and salmon)—Please choose an option— Yes Occasionally No
Does your dog have issues with: Bitting Digging Food possession Fence Jumping Barking Separation anxiety Toy possession Poo eating Mouthing Over excitement People possession Howling/crying Scratching Humping Jumping on people Fireworks Thunder Rain Dog aggression People aggression
Has your dog been referred to us by a professional? —Please choose an option— Yes No
If yes, Who?
Has your dog been socialised? —Please choose an option— Yes No
If yes, how often and where?
In a normal week, how often do you walk your dog and for how long for? And what does it mostly consist of? (on lead foot path, off lead foot path, dog park, park, beach etc.)
What's your dogs favourite game/toy?
Are there any toys/games your dog can't have?
Does your dog like or do you want your dog to have pats and cuddles? Yes No
If it is a hot day, can your dog go in a supervised doggy paddle pool: —Please choose an option— Yes No
Would you like us to celebrate your dogs birthday/adoption date? —Please choose an option— Yes No
Can your dog have birthday cake if it is another dogs birthday? —Please choose an option— Yes No
Is there anything you would like us to do for your dog while they are with us?
Is there anything else we need to know about your dog?
Can we put photo's of your dog up on our social media? Yes No
Where did you hear about us?
Day Care
Days—Please choose an option— Full day Half day Both
How many days a week?
Days:
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