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: ________________________________________________________________
_______________________________________________________________________________________
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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