NEW CLIENT REQUEST FORM

NEW CLIENT REQUEST FORM
Your pets are part of your family, and we want to treat them as the gems they are. Thank you for taking the time to fill this out in as much detail as possible so we can be prepared when we reach out.
Date Completing Form*

MonthDayYear
Date
Name*

Owner 1 (required): First NameLast Name
Name

Owner 2 (if applicable): First NameLast Name
Street Address*
City*
State*
Zip
Email Address*
example@example.com
Phone*
Alternative Phone
How did you hear about us?

YelpPromotionFacebookGoogleFlyerReferralOther
Dog #1 Information:
Name*
Age (please indicate months or years as applicable)*
Breed (if mixed, please list any known)*
Approx. Weight*
Spayed/Neutered*
Dog #2 Information (if applicable):
Name
Age
Breed (if mixed, please list any known)
Gender
Approx. Weight
Spayed/Neutered
VACCINES (Please select Yes/No)
Are they up to date on their Rabies vaccine?*
Date (please provide proof of rabies vaccine via email or at your meet & greet)

MonthDayYear
Date
Have they had a Bordetella (Kennel cough) vaccine in the last 12 months?*
Have they had a Distemper vaccine within the last 12 months?*
Please read the questions below and select Yes / No:
Does your dog experience separation anxiety when away from their human(s)?*
Does your dog play well with a variety of dog genders, breeds, size and age?*
If no, please explain
Has your dog had any formal obedience training?*
If yes, please share some of this info:
Can your dog be off leash and obey voice recall?*
Does your dog have any behavioral issues (shyness with strangers, aggression towards men, women, children, responses to thunder, loud trucks, etc)?*
If yes, please share some of this info:
How do you prefer to be contacted? Please select any that apply and we will use this information to reach out to you regarding your inquiry.*

Phone callTextEmail
Are there any questions you have that you'd like to have answered right away?
Thank you for taking the time to give us some information about you and your favorite pup! We will be in touch as soon as possible to answer any initial questions you might have and schedule a time for a meet & greet.
Should be Empty:

NEW CLIENT REQUEST FORM

Dog #1 Information:

Dog #2 Information (if applicable):

Thank you for taking the time to give us some information about you and your favorite pup! We will be in touch as soon as possible to answer any initial questions you might have and schedule a time for a meet & greet.