Client Questionnaire (Dogs)

Date

Name *

First

Last

Email *

Address

City, State

Zip

Home Number

Work Number

Cellphone

Emergency Contact *

First

Last

Emergency Number

Pets Name *

Date Of Birth

Breed

Color

Sex

Veterinarian Name & Clinic

How long have you had your pet?

From where did you obtain your pet?

Is/ Has your pet CRATE TRAINED?

Is your pet HOUSETRAINED?

How many hours is your pet accustomed to spending in a crate on a daily basis?

Does your pet have any food allergies? If so, please list:

Do you have any objections to us giving your pet treats?

Does your pet suffer from any chronic illness (seizures, stress, diarrhea, etc.)?

Is your dog on any medications or does she/he have any medical problems that we need to be aware of? Please list and explain:

Does your pet guard objects or food from people? If yes, please explain.

Has your pet ever growled at a person? If yes, please explain.

Has your pet ever snapped at a person? If yes, please explain.

Has your pet ever bitten a person? If yes, please explain.

Is your pet afraid of thunderstorms? If yes, do they have medication (type and dosage)?

Has your pet ever jumped or climbed a fence? If yes, list type and height of fence.

Does your pet have any behavioral problems that we should be aware of?

example: "doesn't like small dogs, men, woman, children, strangers, other dogs; doesn't like collar or a specified part of body touched", etc.

Were you referred? If yes by whom?

First

Last

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