Lead By Love Dog Care Registration
Please fill out all that applies
Date
-
Month
-
Day
Year
Date
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Pet's Name
Age of Pet
Also birthdate if known
Breed
Allergies
Current Medications
Current or past ailments
Feeding times/ amount per feeding
Any other feeding instructions
Your dog will be contracting for
Private Lessons
Board & Train 14 days
Board & Train 21 days
Board Only
Board & Walk
Other
Drop off date and time
Pick up date and time
What behaviors is your dog doing that is upsetting you?
Vet information
Name, address, phone number
Vaccinations current
Rabies
Parvo/Distemper
Fecal within 12 months
Bordetella (Kennel Cough) within 6 months
I will provide proof of vaccinations
By email
Hard copy mailed
Hard copy when pet is dropped off
Flea & Tick/ Heartguard
Current with flea and tick (March-November)
Lead By Love to apply flea/tick
Lead By Love to give Heartguard
Spay/Neutered
Yes
No
Has your dog bitten a person?
Never
One time
Many years ago
Other
Has your dog bitten another dog?
Never
One time
Many years ago
Other
Is your dog aggressive towards other dogs?
Yes
No
Other
Has your dog tried to dig under a fence?
Yes
No
Other
Has your dog jumped over a 6 foot fence?
Yes
No
Other
Is your dog crate trained?
Yes
No
Will go in a crate but not crazy about it .
Please work with my dog to help him accept being in a crate.
Other
Yes,I have read and agree to the waiver form and confirm by typing my name below.
Submit
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