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General Information
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Your Name:
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Your e-mail:
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Dog’s Name:
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How long have you owned your dog?
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Where did you get your dog?
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| If adopted, do you have knowledge of your dog’s past history? yes no |
If yes, please describe:
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Number of people in your household?
Adult males: Adult females:
Children/ages:
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Describe how your dog behaves around children:
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List other animals in your household:
Species, Breed, Age, Spayed/Neutered, Sex
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Describe how your dog gets along with other animals in your home:
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| Health
and Grooming |
Does your dog have hip dysplasia?
yes no |
If yes, what restrictions need to be placed on your dog’s activities or movements?
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Does your dog have any health concerns DogDayz needs to be aware of?
yes no |
If yes, what concerns?
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Does your dog take regular medications?
yes no |
If yes, what kind and how often?
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Does your dog have any allergies?
yes no |
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Does your dog like to be brushed?
yes no |
How often do you brush your dog?
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How does your dog react to having his/her nails clipped?
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Does your dog have any sensitive areas of his/her body?
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Where does your dog like to be petted?
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| Behavior
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Do visitors bring their dogs to your home?
yes no |
If yes, how does your dog react?
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How does your dog react to strangers coming into your home or yard?
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Does your dog ever bark or growl at anyone passing by your home or yard?
yes no |
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Are there any kinds of people your dog automatically fears or dislikes?
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Are there any kinds of dogs your dog automatically fears or dislikes?
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How does your dog react to puppies?
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What does your dog do when you are not at home?
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How does your dog act when you get home at the end of the day?
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How does your dog react to other people approaching it when you’re on a walk?
On Lead:
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Off Lead:
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How many times a week is your dog walked?
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How long are the walks?
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Has your dog ever jumped on someone?
yes no |
If yes, what were the circumstances?
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Has your dog ever growled at someone?
yes no |
If yes, what were the circumstances?
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Has your dog ever bitten someone?
yes no |
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Has your dog ever climbed or jumped over a fence?
yes no |
How high was the fence?
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Does your dog have any problems in the following areas? Please describe:
Mouthiness:
Housetraining:
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Barking:
Digging:
Ignoring Commands:
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Is your dog frightened by any noises?
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Is your dog frightened or nervous around anything else?
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Have you ever tried taking food or toys away from your dog?
yes no |
What happened?
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Has your dog shared food or toys with another animal?
yes no |
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Does your dog play with toys?
yes no |
What types of toys/games does your dog enjoy?
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Has your dog had any formal obedience training?
yes no |
If yes, when and where?
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What commands does your dog know?
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Does your dog have a …
Bathroom command:
Quiet command:
Play command: |
Other comments or additional information we should know about your dog?
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You can print the form and fax it to us (317-774-8185)
or fill it out and click send.
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