Intake Form

Name

First

Last

Phone Number

Dog's Name

Dog's Age

Dog's Breed (or best guess!)

Where did you get your dog?

How long have you had them?

If your dog is adopted, do you know anything about their past history/life?

Is your dog spayed/neutered? [check yes/no]

Does your dog have any other medical concerns? If so, what?

Tell me about your dog's personality- are they friendly, shy, etc..?

Is there anything that scares your dog?

What makes your dog happy?

Is your dog potty trained?

Does your dog know any cues or commands?

Tell me about your dog's daily routine?

How much exercise does your dog get daily?

How much time does your dog spend outside daily?

Who lives in your home with your dog?

Are there any people who visit your home frequently?

Does your dog have any behavior concerns?

Does your dog bark at other dogs or people on walks?

Has your dog ever bitten a human or other animal?

Has your dog ever been involved with Animal Control?

Does your dog get along with other animals?

How does your dog react to strangers coming to your home?