New Client Form Open Form New Client Form Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Home Phone (###) ### #### Cell Phone (###) ### #### Work Phone (###) ### #### Email * Person(s) authorized for pick-up Primary Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### Secondary Emergency Contact First Name Last Name Emergency Contact Phone (###) ### #### Dog's Name * Date of Birth * or best guess! Breed(s) * Sex * Male Female Is your dog spayed/neutered? * yes no When and where did you get your dog? If adopted, do you know any of their history? Does your dog have any medical conditions that we should be aware of? Does your dog have any allergies or dietary restrictions? Do we have permission to give your dog treats? yes no Do we have permission to give your dog a peanut butter kong, bully stick or other chew during crated naptime? yes no Do we have your permission to post photos or videos of your dog on our social media or website? yes no Tell us about your dog's behavior and personality! Does your dog have any dislikes, fears or phobias? Has your dog socialized with other dogs before? Please describe their experience with other dogs (this could include puppy kindergarten, daycare or boarding, living with other animals, play dates etc). How does your dog act around other dogs? select all that apply Extremely playful Somewhat playful Nervous or shy Plays rough Likes big dogs Likes small dogs Enjoys running and chasing Enjoys mouthing and wrestling Vocal during play How does your dog react to strangers? Has your dog ever bit or displayed other aggressive behavior towards a person or dog? If yes, please explain. Has your dog had any prior training? If yes, please describe any cues/commands that they know or have started to learn. Describe your dog's experience with crate training. Is your dog comfortable being grabbed/moved by their collar? yes no What do you hope to gain from the Puppy Play & Train or Day School Program? Are there any specific skills you would like us to work on with your dog? Attendance Needs How often would you like to bring your dog to daycare? Once per week 2-3 times per week 4-5 times per week Other Primary Veterinarian * Veterinarian Contact * (###) ### #### How did you hear about us? Thank you!
