Owner Information

 Emergency Contact

Pet Information

Veterinarian

Pet Profile/General Information

Is your pet on special dietary or medical foods? Yes No
What Kind?

Is your pet spayed or neutered? Yes No

If adopted, do you have knowledge of your pet’s history? If yes, describe.

Does your dog like children? Yes No

Describe how your dog behaves around children.

List other animals in your household by:

Describe how your dog gets along with other animals in your household:

Health & Grooming

Does your dog have a flea problem? Yes No

Does your dog have hip dysphasia? Yes No

If yes, what restrictions need to be placed on your dog’s activities or movements.

Does your pet have allergies? Yes No                 If so, to what?

Does your pet like to be brushed? Yes No

How does your pet react to having his/her nails trimmed?

Does your pet have any sensitive areas on his/her body? Describe.

Where are your pet’s favorite petting and scratching spots?

Dog Behavior

Do visitors bring their dogs to your household? Yes No
If yes, how does your dog react?

How does your dog react to being put in a crate?

How does your dog react to a stranger coming into your home or yard?

Does your dog bark, growl, or chase anything passing outside your home or yard?

Are there any kinds of people your dog automatically fears or dislikes?

How does your dog react to puppies?

What does your dog do when you are not home?

How many times per week is your dog walked?

How long are these walks?

Has your dog ever jumped on anyone? Yes No

Has your dog ever growled at anyone? Yes No

Has your dog ever bitten anyone? Yes No
What were the circumstances of the bite?

Has your dog ever climbed/jumped over a fence? Yes No

How high was the fence?

Does your dog have any problems in the following areas? Please describe:
Housetraining Yes No

Barking Yes No

Digging Yes No

Ignoring Commands  Yes No

Is your dog frightened by noises? Describe.

Has your dog ever growled or snapped at anyone taking food or toys away? Yes No

Has your dog ever shared his/her food or toys with other animals? Yes No

Does your dog play with other dogs? Yes No

Does your dog know any tricks?

Has your dog had any formal obedience training? Yes No                When?

What commands does your dog know?

Is it effective in keeping him/her under control? Yes No

What if any bathroom commands does your dog know?

What if any play commands does your dog know?

What if any quiet commands does your dog know?

Cat Behavior

Does your cat get along with dogs? Yes No

Does your cat have a flea problem? Yes No

Is your cat de-clawed? front   back   both

Is your cat litter box trained? Yes No

Does your cat play with any toys? Yes No    

Describe what toys he/she plays with:

List any other comments or information about your dog or cat that might be helpful.