Your Basic Information
Please answer the following questions ahead of your dog's start date.
First Name
*
Last Name
*
Full Address
*
Email
*
Mobile Number
*
Second Contact Name (not yourself)
*
Second Contact Number
*
Emergency Contact Name (different household)
*
Emergency Contact (different household) Number
*
Microchip Number
*
Vet Name
*
Vet Phone Number
*
Vet Address
*
Your Dog's Information
Dog's Full Name
*
What's your dog's sex?
*
Male
Female
Date of Birth
-
Day
-
Month
Year
Are they neutered/spayed?
*
Yes
No
Breed
*
Weight (kg)
*
Your Dog's Health and Vaccinations
Please forward evidence of all vaccinations to team@wagtails.co.uk
DHP Vaccination Expiry Date
*
-
Day
-
Month
Year
Lepto Vaccination Expiry Date
*
-
Day
-
Month
Year
Kennel Cough Vaccination Expiry Date
*
-
Day
-
Month
Year
Do you use a regular worming treatment?
*
Yes
No
What brand of worming treatment do you use?
*
Do you use a regular flea and tick treatment?
*
Yes
No
What brand of flea and tick treatment do you use?
*
Any history of surgeries or orthopaedic conditions?
*
Any medical conditions or regular medication?
*
Any allergies or intolerances that we should know about?
*
Does your dog have lunch? (sadly, we can't cater for raw food)
*
Submit
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