Please answer the questions that follow as thoroughly as possible. Your answers will allow me to serve you better. HEALTH: List current health problems and/or medications of your pet. Does your dog have any allergies, including food allergies? Please provide your Vet information. DIET AND ELIMINATION: What type of food do you feed? (e.g., raw, dry kibble, canned) How often? How much? At approximately what times? Does your dog finish all food at meals? If not, how long is the food left down? Does your dog receive other treats/chewies? If yes how often? Please list 3 of your dog’s favorite foods/treats: Has your dog ever become possessive of his food or a treat? Please describe in as much detail as possible: Is your dog reliably housetrained? O Yes O Mostly (infrequent accidents) O No Is your dog crate trained? Paper/pad trained? Litter box trained? How many times daily do you let your dog out (or take him on walks) to eliminate when you are at home? How many times per day does your dog normally defecate? EXERCISE: What type of exercise does your dog get? How long does the exercise last/how often is it provided? Does your dog ever become reactive toward other dogs or people on walks? If so, please describe: PERSONALITY/ BEHAVIOR: How does your dog get along with the other pet? Does your dog play with toys or play games? If so, what are his favorite toys/games? (These may be interactive games like tug or toys he plays with alone.) What other activities does your dog enjoy? What commands does you dog know? Is there a command that you would like me to work on with your dog? Check the behaviors that apply to your dog: O Aggressive (describe below) O Fearful (describe below) O Anxious when alone O Jumps on people O Pulls on leash O Destructive when alone O Mouthing/nipping O Chews furniture/property O Digs in yard O Urinates in house O Urinates when excited O Defecates in house O Steals food/objects/trash O Darts out doors/gates O Escapes from yard O Guards food/toys/chewies/other O Excessive attention-seeking O Jumps on furniture O Play biting O Stool consumption O Understands but will not obey O Excessive vocalization when alone O Excessive voc. when we’re home O Threatening/biting family members O Threatening/biting strangers O Threatening/growling at other animals O Other (describe below) Has your dog ever bitten anyone? O Yes O No Any animal? O Yes O No If so, please describe in as much detail as possible: What is your dog’s usual reaction when a person he has not met before enters the home? Is there anything else you feel it would be important for me to know?

While your pet is staying with us he will be able to enjoy: - two 1 hours walks per day - play time with my two fur babies Miko and Kirby - plenty of toys - interactive mind games and puzzles - tag games - fetch games - some manners lessons - loads of scratches, petting and love and many more!