Parent(s) Full Name: Cell Phone Number: Dog(s) Name: Breed: DOB/Age: Neutered/Spayed: yes or no Microchipped: Is your dog microchipped and is the microchip contact information updated? Medical Conditions: List any physical and/or emotional conditions and accommodations needed. Medication: If your dog requires medication(s) please list med, dose and frequency. Veterinarian and Emergency Info Eating/Diet: List what food, how much and what times of day does your dog eats? Pee/Poo: Is your dog potty trained? What hours does your dog like to go out to do their business? Walking: Does your dog like walks and does he/she walk well on a leash? Activities: What activities does your dog enjoy and not enjoy? Social Skills: Does your dog get along well with other dogs? Special Needs: Explain your dog’s special need(s) so I can provide the best care possible. High Energy: if your dog is high energy and what is required to satisfy this energy. Destructive: Any chewing, digging or destructive behavior? If so, how do you remedy this at home? Barking: Your dog barks a lot, a little, or somewhere in-between? What triggers his/her barking? Biting: Has your dog ever bitten another dog or person? Aggression: Does your dog have any aggression in any situations? Children: Any aggression towards children? Sleeping: Where does your dog sleep at home? Crate/Confinement: Does your dog require confinement? Furniture: is your dog allowed on beds/sofas?

Ample outings in your backyard and walks around the block and/or to local park and beaches. You know your dog best, so tell me his/her needs so I can accommodate.