Owner Name:*
Dog's Name:
Address:
City/State/Zip:
Home Phone #:
Work Phone #:
Cell Phone #:
E-mail:*
DOG SPECIFICS:
Dog Breed:
Age:
Weight:
Colors/Markings:
Yes, my dog is:
Veterinarian:
Vet Phone #:
Vet Address:
City/State/Zip:
VACCINATIONS: Owner must provide proof of current vaccinations including Rabies (12 months), Distemper (12 months), and Bordetella (6 months). Flea and tick treatment is required. Upon inspection, if it is needed, treatment will be administered at owner’s expense.
CANINE TEMPERAMENT AND BEHAVIOR QUESTIONS (Please be as accurate and detailed as possible)
Does your dog have any separation anxiety issues?
Describe your dog’s general temperament:
How long have you owned your dog?
Where did you get your dog (breeder, pet store, etc.)?
Does your dog get along well with other dogs? People?
Has your dog ever interacted with a large group of dogs?
Has your dog attended daycare or a boarding facitlity before? Any issues?
Has your dog ever growled at or bit another person or dog?
Has your dog ever escaped from a fenced area?
Are there any restrictions on your dog’s activities?
Anything else we should know about your dog?
DOG MEDICATIONS:
Medication 1:
Time & Quantity:
Medication 2:
Time & Quantity:
Medication 3:
Time & Quantity:
DOG DIET:
Brand:
Time & Quantity:
Special Instructions:
EMERGENCY CONTACT DETAILS:
Name:
Home Phone #:
Cell Phone #:
PERSONS AUTHORIZED TO PICK UP OR DROP OFF MY DOG:
Name:
Home Phone #:
Cell Phone #:
How/Where Did You Find Us: (check only one)
IMPORTANT: By submitting this application and using our services for your pets, you agree to our Terms of Service .
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Join The Woof Pack - Olathe Application
