Pet’s Name _________________________________________________________

Breed: _____________________________________   Circle:      MALE       FEMALE

Has your dog been spayed or neutered?   __________

Age: ______________________________  Today’s Date: ____________________

 

1.  Does your dog chew on blankets or furniture?                         YES              NO

2.  Does your dog dig, climb, or is he an escape artist?                 YES              NO

3.  Does your dog suffer from any food allergies?                          YES             NO

If yes, please list: ___________________________________________________________________

4.  Does your dog suffer from any anxiety when you leave?          YES              NO

If yes, please explain: _______________________________________________________________

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5.  Has your dog ever been boarded before?                                 YES              NO

If yes, how did he/she do? __________________________________________________________

6.  Has your dog ever bitten another dog or person?                   YES              NO

If yes, please explain: ________________________________________________________________

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7.   Can we give your dog our treats?                                            YES             NO

8.   Do you want your dog to play with other dogs?                     YES              NO

 

Please list any special needs or concerns you may have: ____________________________

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