Please print out information sheet and fill out completely.

DOG INFORMATION SHEET

 

Client Name:_________________________________________  Phone:

Dog's Name: ___________________________________________

Age:

Breed:

Color/Markings: 

Sex: M or F _____    Neutered / Spayed____________

Rabies tag #:  

Date rabies shot expires:  

Feeding:

What kind of food/s does your dog eat?

 

When does your dog eat?

 

Special feeding instructions:

 

 

Medication:

Is your dog on any medications that must be administered? If yes, please describe the medication procedures including name, dosage and where it is kept.

 

 

Other

Does your dog have a favorite game?

 

Does your dog have favorite hiding places?

 

Where do you keep your collar and leash?

 

Does your dog need a special harness or choke collar for walks?

 

 

Traits:

Please answer the following brief questionnaire about your dog. It will help us to better care for him/her:

 

Is friendly with other dogs  YES / NO

 

Likes new adults   YES / NO

 

Likes children   YES / NO

 

Must stay on leash during walks YES / NO

 

Is allowed in the house  YES / NO

 

Is allowed to have treats  YES / NO

 

Is prone to digging  YES / NO

 

Is prone to chewing  YES / NO

 

Is fearful of noises or other things YES / NO

 

Obeys basic commands   YES / NO

 

Has bitten people or other dogs YES / NO

 

Has shown other aggression YES / NO

 

 

Please indicate anything else about your dog's habits or behavior that would be useful to us in providing care:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

 

 VET & EMERGENCY INFO:

Vet’s Name / Number:

Vet’s Address:

Emergency Vet’s Name/Number :

Emergency Vet’s Address:

Neighbor/Family Emergency Contact Name/Number:

 

 

By signing below I authorize Stephanie Pardue to take my animal, in her care, to the nearest emergency facility- should the need arise. Owner is responsible for all costs associated with visit.

_______________________________________

 

 

 Please be sure to have a collar and an ID tag on all pets!