If adopted, do you have any knowledge of your dog's past history?
How many days a week are your considering doggy daycare?
Preferred days
How did you hear about Grateful Dog?
Health/Grooming
At what age was your dog spayed/neutered?
Is your dog current on ALL vaccinations?
Yes
No
Is your dog currently on heartworm prevention?
Yes
No
What flea program is your dog on?
Does your dog have any food restrictions?
Yes
No
If so, please list
Is your dog on any medications?
Yes
No
If so, please list
Is it okay to give your dog treats during the day?
Yes
No
Does your dog have hip dysplasia?
Yes
No
If yes, what restrictions need to be placed on your dog's activities or movements?
Does your dog have any allergies?
Yes
No
Does your dog like to be brushed?
Yes
No
How does your dog react to having his/her nails clipped?
Does your dog have any sensitive areas on his/her body?
Behavior
Does your dog act afraid of any specific items or noises? If so, please explain
Are there any kinds of dogs your dog automatically fears or dislikes?
How does your dog react to puppies?
Where does your dog sleep at home? (In bed, crate, dog bed)
Has your dog ever:
Growled at someone?
Yes
No
What were the circumstances?
Does your dog have problems in any of the following areas? If so, please explain.
Mouthiness
Housetraining
Barking
Jumping
Others
Has your dog ever growled or snapped at someone who has taken his/her food or toys away?
Yes
No
If yes, what were the circumstances?
Has your dog ever shared his/her food or toys with other animals?
Does your dog play with any toys?
Yes
No
If yes, what kind of toys does your dog like and what games does he/she play?
How often does your dog meet new dogs it does not already know?
Has your dog ever been in a dog fight? If so, what happened?
Has your dog ever had any formal obedience training?
Yes
No
If yes, when and where?
What commands does your dog know?
Does your dog know a bathroom command?
Does your dog know a quiet command?
Does your dog know any play command?
Other comments about your dog that you feel might be helpful:
Health and Temperament Certification
I,
, hereby certify that my dog,
, is in good health and has not been ill with any communicable condition in the last 30 days. I further certify that my dog has not harmed or shown aggressive or threatening behavior towards any person or any other dog.
Enter the code as it is shown below: *
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