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CRITTER COMFORT 'N CARE & CRITTER COTTAGE, INC.

OWNER'S INFORMATION

Name:

 

 

I Mailing Address:

 

 

City:

State:

Zip:

Phone (Work):

(Home):

(Cell):

Who is authorized to pick up your dog from daycare:

 

EMERGENCY CONTACTS I

Name:                                                                     Phone:

 

DOG'S INFORMATION

DAYCARE & KENNEL QUESTIONAIRE                            Dog No. 1        Dog No. 2         Dog No.3

Dog's Name

 

 

 

 

 

 

 

 

 

 

IBreed

 

 

 

 

 

 

 

 

 

 

Gender

 

Male / Female

Male / Female

Male / Female

Weight

 

 

 

 

 

 

 

 

 

 

Age

 

 

 

 

 

 

 

 

 

 

Birth Date, if known

 

 

 

 

 

 

 

 

 

 

Spayed or Neutered?

 

Yes

  /     No

Yes

 /

No

Yes

/

No

How does your dog react to other dogs?

 

Overly-exuberant

Overly-exuberant

Overly-exuberant

 

 

Friendly

Friendly

Friendly

 

 

Relaxed

Relaxed

Relaxed

 

 

Fearful

Fearful

Fearful

How does your dog react to strangers?

 

Overly-exuberant

Overly-exuberant

Over Iy-exuberant

 

 

Friendly

Friendly

Friendly

 

 

Relaxed

Relaxed

Relaxed

 

 

Fearful

Fearful

Fearful

Problems sharing toys/food with other dogs/people?

Yes

/

No

Yes

/

No

Yes

/

No

Is there a problem fighting with other dogs?

Yes

/

No

Yes

/

No

Yes

/

No

 

 

 

 

 

 

 

 

 

 

 

Has your dog ever bitten anyone or another dog?

Yes

/

No

Yes

/

No

Yes

/

No

Any physical limitations or sensitive areas?

Please list

Yes

/

No

Yes

/

No

Yes

/

No

each dogs issues.

 

 

 

 

 

 

 

 

 

 

Allergies or dietary restrictions?

 

 

 

 

 

 

 

 

 

 

Does you do have problems with excessive barking?

Yes

/

No

Yes

/

No

Yes

/

No

I authorize use of citronella collar for excessive barking

Yes

/

No

Yes

/

No

Yes

/

No

Is your dog allowed to socialize with other dogs?

Yes

/

No

Yes

/

No

Yes

/

No

Dog wash for stays over 5 days is included, wash my dog

Yes

/

No

Yes

/

No

Yes

/

No

Any other comments about your dog or concerns you would like us to know about?

 

 

 

 

 

 

How Did you hear about us?

 

 

 

 

 

 

 

 

 

 

                       

 

 

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