Enrollment Application

Pet's Name *

Breed *

Sex *

DOB *

Weight *

Owner Information

Name *

Address *

Email *

Phone - Best way to reach you. *

Phone #2 - Best way to reach you. *

Emergency Contact

Name *

Phone - Best way to reach you. *

Phone #2 - Best way to reach you.

Veterinarian

Name *

Address *

Phone *

Fax

Pet Personality Profile

Dog's Name *

Date you aquired your dog. *

Is your dog spayed/neutered? *

At what age was this done? *

If adopted, what knowledge do you have of your dog’s past history? *

Where did you get your dog? *

Does your dog like children? *

How does your dog behave around children? *

Are there other animals in your household? If so, please list type, sex, and age of each. *

How does your dog get along with your other pets? *

Grooming

Does your dog have a problem with fleas or allergies? *

Does your dog have hip displaysia? *

If yes, what restrictions need to be placed on their activites or movements? *

Does your dog like to be brushed? *

How does your dog react to having his/her nails clipped? *

Does your dog have sensitive areas in her/his body? *

Where are your dog’s favorite petting spots? *

Behavior

Does your dog act afraid of any specific items or noises? *

How does your dog react to strangers coming into your home or yard? *

Does your dog ever bark or growl at anyone passing your home or yard? *

Are there any kinds of people your dog automatically fears or dislikes? *

How does your dog react to puppies? *

Has your dog ever growled at anyone? What were the circumstances? *

Bitten someone? What were the circumstances? *

Does your dog have any problems in any of the following areas? *

Mouthiness

Barking

Digging

Housetraining

Jumping

If you marked yes in any of the above please explain. *

Has your dog ever growled or snapped at someone who has taken his/her food or toy away from him/her? *

Has your dog ever shared his/her food with other animals? *

Does your dog play with any toys? *

What kinds of toys or games does your dog like to play? *

Does your dog play with other dogs? *

Has your dog ever had any formal obedience training? *

What commands does your dog know? *

Other comments about your dog that you think might be helpful? *

Owner Information

Emergency Contact

Veterinarian

Pet Personality Profile

Grooming

Behavior

For Office Only

Categories