Bentley's Legacy Dog Intake Form

How Did you hear about Bentley's Legacy?

Which services were you inquiring about?

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Spouse

First NameLast Name

Spouse's Email

example@example.com

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What is your dogs name:

What is your dogs Breed/Mix (if known):

Birthday/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 NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

What is your dogs primary Veterinary office?

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is your house trained and/or crate trained? Select all that apply.

How would you rate your dogs energy level?

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?

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?

Is there anything else that I should know about your dog?