805 474-8092

How did you hear about us:
Home Phone:
Work Phone:
Driver's License:
Dog(s) Name:
Sex: Male Female
Emergency Number/Name (if you had a problem returning from a trip, who would take your dog):
Proof: Rabies Distemper Parvo-Virus Spayed/Neutered
Where does your dog normally sleep? (i.e., on your bed, in a bed in your bedroom, in a crate, etc.)
How is his/her day time spent? With other animals Other Humans Mostly alone Never alone
How would you describe your dog's personality (check all that apply)? Aggressive Playful Easygoing Temperamental Passive Unpredictable
Separation Anxiety (rate on a scale of 10 to 1 - 10 being the highest)
Is your dog house broken? Yes No Somewhat
Is your dog likely to have accidents in the house? Yes No
Chew on furniture? Yes No
Other Behavior challenges?
Is your dog likely to try to dig out of fenced areas? Yes No Not sure
Is your dog likely to try to jump a 6 foot fence? Yes No Not sure
What is your Dog(s)'s food routine? How often does he/she eat?
Is your dog allowed to have human food?
Does your dog have any food allergies?
If yes, please indicate:
Please describe your dog's social experiences (check all that apply)
Dog Park: Occasionally Weekly Monthly Never
Plays with other dogs: Occasionally Regularly Daily Rarely Never
Describe your dog's behavior towards other dogs (check all that apply): Playful Shy Aggressive Attacking Unpredictable Not sure
Has your dog been professionally trained? Yes No
Successful? Yes No
Name/Contact for trainer (if applicable)
Did your dog ever bite anyone?:
Did your dog ever bite another dog?
What kind of flea control do you use?
Date of most recent flea treatment:
Language used for "go to the bathroom"
What are your major concerns about taking your dog to Daycare or Boarding?
What dog care options have you used in the past (check all that apply)? Kennels In home Dog(s) care Friend/Family
What has worked/not worked?
Please indicate special routines or activities that make your dog especially happy (examples:loves having tummy rubbed, loves playing with me every morning before work, etc.)
Anticipated dog care requirements: (check all that apply)
Daycare: Hourly Daily Weekly Monthly
Overnight Boarding 1 or 2 days 3 days or more Weekly Monthly
Dates for which you want daycare/boarding:
SPECIAL NEEDS: Please let us know about any special needs of your dogs, including, food, medicine, health, psychological or social issues:
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Contact Us

To schedule an prescreening interview, daycare, boarding, or training services, please feel free to contact us!
Phone: (805) 474-8092

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