Dog Day Care Emergency Contact Information

Owner Information
Name: Address: E-mail:
Home phone: Work phone: Cell phone:
Other:

Emergency contact (other than above)
Name: Home phone: Work phone:

Pet Information
Name: Breed: Birthdate: Weight:
Gender: Male Female

Veterinarian Information
Name: Clinic: Address: Phone:

Pet Personality Profile

General Information
How did you hear about our daycare?
Date you acquired dog:
Spayed/Neutered?: Yes No
At what age?
Where did you get your dog?
If adopted, do you have any knowledge of your dog’s past history? Yes No
Does your dog like children? Yes No
How does your dog behave around children?
Do you have other animals in your household? Yes No
If so, list type, sex and age of each:
How does your dog get along with other resident animals?

Health/Grooming
Does your dog have any problem with fleas? (ie. allergies)
Other allergies?
Does your dog have hip dysplasia, bone/joint, arthritis problems?
If yes, what restrictions need to be placed on your dog’s activities or movements?
How does your dog react to being brushed? Wiped with towels, feet handled, nails trimmed, etc.?
Any sensitive areas on his/her body?
What are your dog’s favorite petting spots?

Behavior
Does your dog act afraid of any specific items or noises? Yes No
If so, please explain:
How does your dog react to strangers coming into your yard or home?
Does your dog ever growl or bark at anyone passing outside your home or yard?
Are there any kinds of people your dog automatically fears or dislikes?
Are there any kinds of dogs your dog automatically fears or dislikes?
How does your dog interact with puppies?
Has your dog ever: Growled at someone? Yes No
What were the circumstances:
Bitten someone? Yes No
What were the circumstances?
Does your dog have problems in any of the following areas: (if so, please explain)
Mouthiness: Housetraining: Barking:
Digging: Jumping: Other:
Has your dog ever growled or snapped at anyone who has tried to take his/her food or toys away from him/her? Yes No
If yes, what were the circumstances?
Has your dog ever shared his/her food or toys with other animals? Yes No
Does your dog play with toys? Yes No
If yes, what kinds does your dog like and what games does he/she play?
Does your dog play with other dogs? Yes No
Has your dog had any formal obedience training? Yes No
If yes, when and where?
What commands does your dog know?

Other comments about your dogs personality which you feel may be helpful: