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Owner Information:
Name:
Address:
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Additional Owner Information:
Name:
Address:
Phone:
Cell:
Email:
Dog Info:
Name:
Age:
Breed:
Sex:
Weight:
Additional Dog Info:
Name:
Age:
Breed:
Sex:
Weight:
Veterinary Clinic Info
Emergency Contact Info
How does your dog react when another dog approaching him/her?
Does being on or off leash make a difference?
YES
NO
Are there any particular breeds of dog your pet is afraid of?
YES
NO
If yes please specify
Has your dog played off leash with other dogs before?
YES
NO
Is your dog crate trained?
YES
NO
Is your dog house trained?
YES
NO
What is our dog's reaction to puppies?
Is your dog frightened of thunderstorms or other noises?
YES
NO
If yes, what can we do to soothe him/her?
Does your dog have any sensitive areas on their body we should avoid?
Does your dog have any allergies we should watch for?
Does your dog have any disabilities or old injuries?
Are there any restrictions that should be placed on your dog's activities?
Does your dog have any behaviour issues or destructive habits?
How long have you owned this Dog?:
If adopted what knowledge do you have of dog's past history?:
Does your dog share food or toys with other animals?
YES
NO
Has your dog ever bitten or attacked another dog?
YES
NO
If yes please explain -
Has your dog ever growled at or bitten a person?
YES
NO
If yes please explain -
Does your dog climb or jump fences?
YES
NO
Is your dog possesive of:
Food?
YES
NO
Toys?
YES
NO
Space?
YES
NO
People?
YES
NO
How does your dog react when approached by strangers?
At Home?
In the Yard?
Out in Public?