OZ - Day Stay Intake Form
Please complete the following questions.
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Veterinary Information
*
Vet Clinic Name
Phone Number
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Your Dog's Name
Dog's Name
Your Dogs Age
*
Ex: 2 years
Your Dogs breed? Mix?
*
Is Your Dog Spayed/Neutered?
*
yes
no
Is Your Dog Up To Date On Immunizations (Rabies & DA2PP)? Check all that apply. *Must have Rabies & DA2PP for any services.
*
Rabies
DA2PP
Bordetella (optional)
Please Upload Copy of Immunization Record
*
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Length of ownership?
*
Ex: 3 months
Where does your pet come from? Breeder, shelter, etc?
*
Does Your Dog Have Any Behavioural Issues? Please Explain...
*
Has Your Dog Ever Bitten Anyone?
*
Yes
No
Briefly Explain The Circumstances of the Bite Incident.
Would You Consider Your Dog to Be Reactive to any of the following?...
Humans
Other Dogs
Vehicles
Children
Other
How Much Physical Exercise Does Your Dog get Each Day?
None
Less than 30 minutes
1-2 Hours
2+ Hours
What Type of Physical Exercise Does your Dog get?
Walking
Games (Fetch, tug, etc)
Other
How Much Mental Exercise Does Your Dog get Each Day?
None
Less than 30 minutes
1-2 Hours
2+ Hours
What Type of Mental Exercise/Stimulation Does your Dog Get?
Obedience/Training
Puzzle Games/Toys
Other
Is Your Dog Crate Trained?
Yes
No
What Training Tools Have You Tried?
Slip Leash
Prong Collar
E-Collar
None
Other
Are You Open To Incorporating A Variety Of Training Tools To Support Your Dogs Behaviour Development & Training?
Yes
No
Not Sure
How Often Does Your Dog Eat?
Once
Twice Per Day
Three Times per Day
Free Fed
Submit
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