Boarding-Board & Train Intake Form

First name

Last name

Phone

Address

Pet Name

Pet Breed

Pet Weight

Spayed/Neutered?

Yes

Emergency Contact Person Information

Name

Phone

Preferred Vet Information

Name

Phone

Address

Food Brand/Daily Feeding Amount

Known Allergies

Current Medications/Dosage

Flea & Tick Administer Date

Heartworm Prevention Administer Date

Last Bordetella Vaccination Date

Last Rabies Vaccination Date

Is your dog crate trained?

Does your dog have a bite history (any teeth contact to skin of another dog or human )? Please describe.

Does your dog exhibit separation anxiety when you leave the house? Please describe.

Where does your dog normally sleep at night?

What is your dog's current feeding schedule?

Why are you hiring a trainer for your dog? And/or why are you boarding your dog?

What are your main training goals/concerns for your dog?

Has your dog ever had a seizure, suffered from bloat, intestinal blockages or other emergency medical episodes your trainer should be aware of?

Preferred Start Date:

End Date (Board Only Clients):