INFORMATION QUESTIONNAIRE(Please complete 1 questionnaire per dog) Services Interested In? Approximate Dates / Time Frame? (ex. daycare, boarding,) (ex. Aug. 9 - 12) Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email Emergency Contact Name / Phone Number Veterinarian Office Name / Phone / City / State * Dog Name * Breed * Sex / Spayed / Neutered * Approximate Age * Approximate Weight * How long has your dog lived with you? How often does your dog interact with other people/dogs outside the home? Any behavioral issues / special needs? * Provide additional comments below as needed.... No Yes Any allergies or medications required? * Provide additional comments below as needed.... No Yes Has bitten another dog / human? * Provide additional comments below as needed.... No Yes Growls or snaps over toys, food or treats? * Provide additional comments below as needed.... No Yes Has been to a trainer or daycare? * Provide additional comments below as needed.... No Yes Has been boarded before & did well? * Provide additional comments below as needed.... No Yes Acts calm & rests well in a crate? * Provide additional comments below as needed.... No Yes Sleeps in bed with us? * Provide additional comments below as needed.... No Yes Additional comments Thank you!
