Registration
www.dustysdoghouse.com
Owner Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
-
Area Code
Phone Number
Home Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Emergency Information
Emergency Contact (Not Yourself)
Emergency Contact Phone Number
-
Area Code
Phone Number
Dog Information
Dog's Name
*
Breed
*
Sex
*
Male
Female
Spay / Neutered?
*
Yes
No
Weight
*
Color
Birthday
Veterinarian Information
Name
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Other People Authorized To Pick Up My Dog
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Relationship
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Relationship
About Your Dog
Has your dog attended daycare before?
Yes
No
Have you boarded your dog before??
Yes
No
If yes, please describe your dog's experience.
Do you use flea/tick control on your dog?
Yes
No
If yes, which one?
Does your dog have any allergies? food /medicine
Yes
No
If yes, please describe.
Does your dog take any medications?
Yes
No
If yes, please describe.
Has your dog ever bitten anyone?
Yes
No
If yes, please describe.
Is your dog frightened by storms or loud noises?
Yes
No
If yes, please describe typical behavior and what helps alleviate it.
Has your dog ever growled or snapped when food or toys are taken away?
Yes
No
If yes, please describe.
Are there any particular types of people your dog seems to dislike immediately? (children, people in uniforms...)
Feeding Directions While Boarding at Dusty’s Dog House
My dog eats
Breakfast
Lunch
Dinner
Breakfast:
Lunch:
Dinner:
Special Feeding Instructions:
If you have electronic copies of your vaccines you can upload them here:
Browse Files
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*
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