Puppy Daycare Registration Form
Please complete all relevant sections
Contact Information
Required
Full Name
First Name
Last Name
Address
City, Province
Postal Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Emergency Contact
First Name
Last Name
Phone Number
Canine Information
Required
Puppy's Name:
Date of Birth (DD/MM/YY):
Breed:
Sex:
Intact Male
Neutered Male
Intact Female
Spayed Female
Color:
Weight:
If known
Medical Information
Current/Regular Veterinarian Clinic
Vaccine History
Required
DA2PP (Choose most recent)
First booster
Second booster
Final booster
Date Given (DD/MM/YY)
Rabies (DD/MM/YY)
If applicable
Bordetella (DD/MM/YY)
If applicable
Please attach your puppys vaccine records:
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Does your dog have allergies? If yes, please list:
Lifestyle and Background Information
How would you describe your puppy's energy level?
Low
Moderate
High
Extremely high
What types of exercise does your puppy get on a typical day? (Example: leash walks, off leash dog park, daycare, play time, etc.) Please also include approximate duration, and how often they occur:
Did your puppy participate in our Puppy Social class?
Has your puppy had any negative experiences with other dogs before? If yes, please explain.
Please list 3 things you wish your puppy would learn.
Please list 3 things you wish your puppy would not do.
Please describe any other information or concerns you have, that you feel we would benefit from knowing about your puppy.
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