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Cammino Canino
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Should the invoice be issued to the Primary Contact?
*
Yes
No
Other
Full Name
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First Name
Middle Name
Surname
Email
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Partita IVA (VAT Number)
Address
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Street
City
City
Region
Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Additional Contact
Full Name
First Name
Surname
Cell Phone
-
Country Code
Phone Number
Emergency Contact
Is it the same as the Additional Contact?
*
Yes
No
Full Name
*
First Name
Surname
Cell Phone
*
-
Country Code
Phone Number
Communications
Would you like us to create a WhatsApp group with the Primary as well as the Additional Contact?
*
Yes
No
Is there another person you'd like us to add to the WhatsApp group?
*
Yes
No
Cell Phone
-
Country Code
Phone Number
Cell Phone
-
Country Code
Phone Number
Veterinary Information
Clinic Name
*
Cell Phone
*
-
Country Code
Phone Number
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Dog's Information
Pup's Mugshot
Upload Photo
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Name
*
Date of Birth
*
/
Day
/
Month
Year
Breed
*
Gender
*
Male
Female
Weight/Size
*
Small: up to 10 kg (22 lbs)
Medium: 10-25 kg (22-55 lbs)
Large: 25-40 kg (55-88 lbs)
Giant: 40+ kg (88+ lbs)
Microchip Status
*
Yes
No
Sterilization Status
*
Yes
No
Has your dog shown mating behaviors or marking indoors?
*
No
Yes
Please elaborate:
*
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Health
Are your dogs vaccinations up to date?
*
Yes
No
Does your dog have any ongoing or recurring medical condition? (even if irregular)
*
Yes
No
Please elaborate:
*
Does your dog take medication?
*
Yes
No
Medication Name, Dosage/Frequency and Administration Instructions:
*
Does your dog regularly receive preventative treatments for fleas and ticks?
*
Yes
No
Administration
Collar (ex. Scalibor, Seresto)
Topical Treatment (ex. Advantix, Frontline)
Oral Administration: Monthly (Frontpro, Elanco AdTab)
Oral Administration: Every 3 Months (Bravecto)
Does your dog have dietary or environmental allergies?
*
Yes
No
Please elaborate:
*
What symptoms does your dog exhibit during an allergic reaction?
*
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Dog Behaviour
Does your dog exhibit any destructive behaviours?
*
Yes
No
Please elaborate:
*
Has your dog been looked after by someone else before?
*
Yes
No
Please elaborate:
*
My dog can share the home with:
*
None of the below
Un-neutered Male dog
Neutered Male dog
Female dog
Please elaborate:
*
Has your dog ever done any of the following:
*
None of the below
Attacked and/or bit another person
Attacked and/or bit another animal
Attacked and/or bit another dog
Please elaborate:
*
Has your dog ever had potty accidents in the house?
*
Yes
No
Did the accidents happen because the dog is currently a puppy?
*
Yes
No
How frequently do they take place?
*
rarely
somewhat regularly
very regularly
Is there a risk your dog may escape?
*
Yes, please attach Apple AirTag
No
I'm not sure
Are there any fears, sensitivities, or behaviors we should be aware of?
*
None of the below
Hot Days
Cold Days
Rain/Thunderstorms
Bicycles/Scooters
Food/Resource Guarding
Seperation Anxiety
Vacuum
Other
Does your dog have any age related special needs?
Does your dog know any commands?
*
Yes
No
Please list:
*
Is your dog reactive to:
*
None of the below
Un-neutered male dogs
Neutered male dogs
Female dogs
Strangers
Cats
Children
Other
Please select all that apply while out on walks
*
None of the below
Pulls on the leash
Reactive towards other dogs
Reactive towards other people
Jumps on people
Tries to eat things
Other
Is there anything else I should know about your dog?
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Feeding Instructions
(OPTIONAL)
What type of food does your dog eat?
Dry Food (kibble)
Fresh Food (homemade)
Wet Food (canned)
Specify which meals your dog eats:
1. Breakfast
2. Lunch
3. Dinner
What is the quantity for each meal?
Specifications regarding food preparation
Can your dog eat treats provided by us?
*
Yes
No, we will provide the treats
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Confirmation of Service Agreement & Liability Waiver
Full Name
*
First Name
Surname
Place
*
Date
*
/
Day
/
Month
Year
Date
Service Agreement
*
Liability Waiver
*
Confirmation of Consent Agreement
Veterinary Consent
*
Photo/Video Consent (optional)
Off-Leash Consent (optional)
Type Full Legal Name
*
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