Enrollment Application

Pet's Name *

Breed *

Sex *

DOB *

Weight *

Owner Information

Name *

Address *

Email *

Phone - Best way to reach you. *

Emergency Contact

Name *

Phone - Best way to reach you. *

Phone #2 - Next best way to reach you

Email

Veterinarian

Name *

Address *

Email

Phone *

Fax

Pet Personality Profile

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? *

For Office Only

Enrollment Form

Enrollment Fee

Shots

Screened

Computer Entry

First Day

Owner Information

Emergency Contact

Veterinarian

Pet Personality Profile

Grooming

Behavior

For Office Only

Categories