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OWNER & DOG INFORMATION
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Owner First Name
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Owner Last Name
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Dog's Name
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Breed
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Weight
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Sex
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Male
Female
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Neutered?
Yes
No
Dog's must be spayed/neutered if over the age of 6 months.
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Color/Description
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DOB (if unsure, please estimate):
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(MM/DD/YYYY)
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Vet/Clinic Name
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Vet/Clinic Phone Number
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CONTACT INFORMATION
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Home Address
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City
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State
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Zip Code
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Home Phone
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Work Phone
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Cellular Phone
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Alternate Phone Number(s)
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Email
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Emergency Contact Name
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Emergency Contact Phone |
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How did you hear about DogBoy's?
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If other, please specify:
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GENERAL INFORMATION ABOUT YOUR DOG
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How old was your dog when you got him/her? (if unsure, please estimate)
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How and/or where did you get your dog?
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What was your primary reason for getting a dog?
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Companion
Protection
Gift
To Breed
For Child
For Other Dog
Replace Previous Dog
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Is your dog a (check all that apply):
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Digger
Chewer/Shredder
Barker
Fence Climber
If fence climber, list type of fence and height
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Does your dog exhibit any destructive chewing?
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Yes
No
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If yes, check all that apply:
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Impersonal items:
Furniture
Flooring
Doors
Other
Personal items:
Socks
Underwear
Clothing
Shoes
Other
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Is your dog sound or sight sensitive (check all that apply):
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Thunderstorm
Lightening
Firecrackers
Other
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Likes to play with (check all that apply):
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Women
Female Dog
Men
Male Dog
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Is your dog (check all that apply):
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Dog Aggressive
Human Aggressive
Please explain:
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Has your dog ever bitten anyone?
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Dog
Adult
Child
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Did he/she break skin?
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Yes
No
Please explain:
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Favorite Games w/Family/Owner (check all that apply):
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Tug/Fetch
Chase
Wrestle
Hide & Seek
Walks
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Where are toys kept?
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Toy Box
Throughout House
Out of Reach
Yard
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Favorite Toys
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Favorite Treats
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Spends
% of time in-doors and
% of time outdoors
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Where does your dog sleep? (check all that apply):
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Owner's Bed
Bedroom
Sofa
Living Room Floor
Kitchen
Outside
Other
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Is your dog house-trained?
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Yes
No
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How does dog react to crate?
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Love
Tolerate
Hate
Destroy |
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On a scale of 1-5, how easy is it to groom your dog (ie - Bath, clip, brush)?
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Easy ----------------------------------Difficult
1
2
3
4
5
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What BRAND of dog food do you feed (main meals)?
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Check any additional items your dog consumes:
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Dog Treats
Cat Treats
Table Scraps
Bones
Cat Food
Feces
Other
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Check feeding habits:
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Free feed
Three times a day
Twice a day
Once a day
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Does your dog have any allergies?
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Yes
No
If yes, specify:
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Is your dog taking any medications?
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Yes
No
If yes, specify:
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Has your dog ever had seizures?
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First
Last
Medications
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How do you control/correct misbehavior (check all that apply)?
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Shock collar
Choke/prong collar
Time out
Alpha Roll
Newspaper/Magazine
Verbal (explain)
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Please list behavior problems and/or goals for your dog:
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Special Instructions
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I have read and agree to the Rules of the Game
(by selecting the check box above, you are giving your online signature that the statement is true and correct)
Today's Date
(MM/DD/YYYY)
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