Intake | Dog Day Care

Intake Form

First name

Last name

Address

Email

Primary Phone Number

Back Up Phone Number

Dog's Name

Dog's Age

Breed

Sex (Male/Female):

Spayed/Neutered? (Yes/No): If not when?

Date of Last Vaccinations:

Is your dog social with other dogs?

Has your dog ever shown aggression toward people or dogs? If yes, please describe

Would you like your dog socialized with children? (Yes/No):

Does your dog have any behavioral concerns we should know about?

How many days a week are you looking for your dog to come?

Does your dog need pickup/drop-off service? (Yes/No):

Preferred Pickup/Drop-off Times (if applicable):

Are we allowed to take your dog on car rides / short trips?

Vet Name and Phone Number

Emergency Contact 1

Emergency Contact 2

Any additional notes