Pawsitive Puppy Program Application
This form is required to be completed before your dogs first day of daycare. You must fill out 1 application per dog.
Email address *
Client Information
Owner Name: (Please include all owners in the household, ie. Spouse or significant other) *
Your answer
Mailing Address (including PO Box) *
Your answer
Mobile Number: (Please include both numbers if multiple owners) *
Your answer
Home Number:
Your answer
Work Number:
Your answer
Email: *
Your answer
Best way to contact you during the day: *
Emergency Contact Person: (Someone who is not the dogs owner) *
Your answer
Emergency Contact Phone Number: *
Your answer
Alternate Emergency Contact (Name & Number)
Your answer
How did you hear about us? (If a person, please let us know who to thank!) *
Your answer
Would you like to receive our Newsletter? *
Puppy's Information
Puppy's Name: *
Your answer
Puppy's Birthday *
MM
/
DD
/
YYYY
Sex: *
Is your puppy spayed/neutered? (Please note all dogs over 1 year must be fixed in order to come to daycare) *
Breed: *
Your answer
Veterinary Clinic: *
Your answer
Tell us more about your puppy!
Where did you get your Puppy? *
Your answer
Has your puppy played/interacted with: *
Required
Which of the following best describes your puppy’s level socialization with other dogs *
Has your puppy had any problems previously in an off-leash social environment? Select all that apply: *
Required
Please describe if any concerns mentioned above?
Your answer
Has your puppy attended daycare or playgroups somewhere else? *
If Yes - Where?
Your answer
Has your puppy been to a dog parks? *
If Yes - Where?
Your answer
Does your puppy have formal obedience training? *
If Yes - Where?
Your answer
How are you currently house training your puppy? (ie. bells, rewards, praises, let out in backyard) *
Your answer
Besides in play or during your puppies gremlin hour has your puppy ever bit another dog or person? *
Your answer
Has your puppy ever dug under, climbed or jumped a fence? *
Your answer
Does your puppy have any areas on the body that he/she doesn’t like petted? *
Your answer
Are there any breeds of dogs that your puppy fears or dislikes? *
Your answer
Is there anything your puppy is particularly afraid of? *
Your answer
Will your puppy let you take his/her food away while eating? *
How does your puppy react to confinement (loves his crate, fine, whines, hates it, etc)? *
Your answer
Is there anything else we should know about your puppy? *
Your answer
Puppy's Medical Information
Please provide details on your puppy's diet: What type of diet is your dog fed? (Kibble, dehydrated, raw) *
Your answer
What brand of food is your puppy fed? (Performatrin, Purina, Royal Canin etc) *
Your answer
What is the primary protein source? (Chicken, Lamb etc) *
Your answer
How often do you feed your puppy? (once a day, twice a day etc) *
Your answer
Any Current or Ongoing Medical Conditions? *
Your answer
Is your puppy taking any medications? Please include name of medication *
Your answer
What Type of Flea Prevention is your puppy on: (please note your dog must be on flea prevention during the summer months and we recommend yearly) *
Your answer
Does your puppy have any allergies or food sensitivities? *
Your answer
May we feed your puppytreats? *
Is it OK for us to take photos of your puppy that might be posted on our website, Facebook, other social media or promotional material? *
Do you have any peanut allergies in the household? We regularly use peanut butter to stuff kongs. *
Your answer
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This form was created inside of Unleash the Pawsitive.