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First & Last Name *
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Spouses First & Last Name
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Address *
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City *
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ZIP Code *
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Email *
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Home Phone *
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Cell Phone *
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Employer *
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Work Phone *
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Spouses Employer
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Spouses Work Phone
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Emergency Contact Name *
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Emergency Contact Number *
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Dog Name *
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Breed *
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Age *
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Date Of Birth
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Sex *
Spayed Or Neutered *
Weight *
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How long have you owned your dog? *
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Where did you get your dog? *
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If your dog is adopted, do you know about your dog's history? Please explain.
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Veterinary Office Name *
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Veterinary Number *
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Veterinary Address *
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Select the reason/reasons you have chosen day care for your dog. *
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Has your dog been to daycare before? *
Is your dog house broken? *
Has your dog attended or received basic obedience training? If so, please mention the highest level of training that was completed.
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Select any of the following commands your dog knows. *
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Does your dog have a bathroom command? *
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What signals does your dog use to show you they have to use the bathroom?
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Does your dog have a play command? If so, please explain.
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Does your dog do any of the following a home? *
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If there are any other problems at home please explain.
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Is there anything in particular that frightens your dog?
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Are there certain words that over-excite your dog?
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Are there other animals that over-excite your dog?
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Are there certain objects that over-excite your dog?
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Are there certain activities that over-excite your dog?
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How does your dog react when you enter your home? *
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Is your dog protective of you when around other dogs/people? *
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Is your dog protective of other household family members when around other dogs/people?
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How does your dog react when visitors come over? *
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How does your dog react when people come near your yard?
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How does your dog react to strangers? *
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Are there people your dog automatically seem to LIKE? *
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Are there people your dog automatically seem to DISLIKE? *
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Has your dog ever growled or snapped at ANY person? *
Has your dog bitten (made contact with teeth) at ANY person? *
Is your dog protective of other people when around other dogs?
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How often has your dog had the chance to play with other dogs? *
Describe how your dog plays with other dogs.
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How many other dogs has your dog had the chance to play with.
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Are there any kinds of dogs that your dog seems to prefer?
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Are there any kinds of dogs that your dog seems to dislike?
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How does your dog react when he/she sees another dog ON LEASH? *
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How does your dog react when he/she sees another dog OFF LEASH? *
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How does your dog react when actually approached by another dog ON LEASH? *
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How does your dog react when actually approached by another dog OFF LEASH? *
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Has your dog ever shared toys with another dog? *
Has your dog ever shared a food/water dish with another dog? *
Has your dog ever been in an altercation or fight with another dog? *
Has your dog ever wounded another dog in any way? *
Is your dog used to being in a crate? *
Does your dog object to being in a crate? *
Where does your dog sleep at night? *
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Where does your dog stay when you're not at home? *
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Is your dog protective of his/her resting area? *
Does your dog like to play? *
Describe how your dog plays with you?
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Is your dog protective of toys? *
Does your dog chew on items he/she shouldn't? *
What do you feed your dog? how many times per day? *
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Is the food bowl left out with food in it all day? *
Does your dog get treats? What kind?
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Is your dog protective of his/her treats or food?
Is your dog protective over rawhide/bones?
Is there anything you do not allow your dog to eat?
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Does your dog have any medical conditions other than those that may been mentioned?
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Does your dog require any medication? If so, please name.
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Does your dog allow you to groom and/or brush them?
Do you send your dog to the groomer to be bathed and/or brushed?
Does your dog behave at the groomer?
How does your dog react to having their nails clipped?
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Are there any places your dog doesn't like being touched? *
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Where is your dogs favorite spot to be pet? *
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How did you hear about paw play? *
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