Bentley's Legacy Dog Intake Form

Dog Intake Form

Bentley's Legacy
How Did you hear about Bentley's Legacy? *
Which services were you inquiring about? *

Dog Camp Basic Obedience Training Boarding Potty Breaks Dog Walking Other
Name *

First Name Last Name
Email *
example@example.com
Spouse

First Name Last Name
Spouse's Email
example@example.com
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
What is your dogs name: *
What is your dogs Breed/Mix (if known):
Age (approx): *
Weight (approx): *
Is your dog spayed/neutered? *
Is your dog current with all preventatives and vaccinations? *
Does your dog have a secure collar with ID tags? *
Does your dog have any medical issues or food allergies? *
Has your dog ever bitten a person? *
Has your dog ever attacked or seriously injured another dog/animal? *
Emergency Contact *

First Name Last Name
Phone Number *
Please enter a valid phone number.
What is your dogs primary Veterinary office? *
Phone Number *
Please enter a valid phone number.
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Is your house trained and/or crate trained? Select all that apply. *

My dog is house-trained My dog is crate trained My dog is still potty training
How would you rate your dogs energy level? *

Low Moderate High
Has your dog ever gotten loose, tried to run away, jumped or climbed a fence? *
How is your dogs recall? If they are off leash, will they reliably come back to you when called? *
What training techniques is your dog accustomed to? *
What commands does your dog know and/or what commands are you working on? *
Does your dog have any dislikes, fears or situations that might be anxiety provoking for them? i.e loud noises, men with hats, vacuums etc *
Has/does your dog engage in any destructive activities? *
Do you have any objection to treats as a means of positive reinforcement? *

Yes No
Has/does your dog guard people, objects, or food? *
Is your dog comfortable and/or relatively at ease with riding in the car? *
Is your dog reactive to other dogs on/off leash? *
Do you use a harness or a gentle leader to walk your dog? *
How would you rate your dogs prey drive? *
What is your dog’s play style? Do they enjoy playing with other dogs? Do they like to play rough or have a more casual type of play? *
Are there any special toys, specific treats or items you would like to send for me to have on hand for your dog? *
Are you OK with your dog's photo being used on Bentley's Legacy's social media? *

Yes No
Is there anything else that I should know about your dog? *
Should be Empty:

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