Dog Profile

Boulder Puppy Enrollment Form
Please submit one form per dog you plan to enroll.
Dog's name
Parents' names (list all)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Primary phone

Area CodePhone Number
Phone Other #1

Area CodePhone Number
Phone Other #2

Area CodePhone Number
Dog's breed
Dog's birth date

MonthDayYear
Gender
General Information
Food type
Please describe meal preparation details and timing
Has you dog ever been enrolled in day care before? If yes, where?
If referred, how?
Emergency Information
Emergency contact person (other than self or spouse)

First NameLast Name
Phone number

Area CodePhone Number
Relationship
Vet clinic
Treating veterinarian
Phone number

Area CodePhone Number
Vaccination/Medical History
We require written proof of vaccinations from your veterinarian prior to attendance.
Rabies due
DHLPP due
Bordatella due
List any known allergies
Yearly Heartworm Test? If yes, what brand of preventative?
Flea and Tick Medication? If yes, what brand of preventative?
Describe any medical/health issues we need to be aware of (i.e. heart/hip problems, seizures, etc.)
Anything contagious? If yes, what?
Microchip number:
Microchip brand:
Dog's Profile
How long has your dog been in your family?
Where did you get your dog?
If adopted, do you have any knowledge of your dog’s past history?
How many people are in your family?
Of the number above, how many children do you have?
If you have children in your family, what are their ages?
Has your dog had any obedience training?
If "yes" in the previous question, to what level?
Do you use a crate? If yes, are they comfortable in the crate?
Is your dog comfortable with having his/her feet touched?
Is your dog comfortable with having his/her collar used to lead?
Has your dog ever climbed or jumped a fence?
Has your dog ever growled or snapped at anyone who’s touched his/her bones, food, or toys?
Does your dog play with other dogs on a regular basis? If yes, describe how they play.
Does your dog prefer certain a certain sex of dogs? If yes, which sex?
Does your dog automatically dislike certain types of dogs? If yes, what kinds?
How does your dog react to strangers?
Does your dog automatically dislike certain types of people? If yes, what kinds?
Describe any behavioral problems/ idiosyncrasies/ special sensitivities we should be aware of.
PLEASE NOTIFY US IMMEDIATELY IF ANY OF THIS
INFORMATION CHANGES!
Should be Empty:

Boulder Puppy Enrollment Form

General Information

Emergency Information

Vaccination/Medical History

Dog's Profile