10401 Green Road P.O. Box 305

10401 Green Road P.O. Box 305

Bealeton, VA 22712

540-439-PAWS(7297) FAX 540-439-8021

DOGGY DAYCARE

Owner’s Name______Date ______

Dog Profile

Dog’s Name______Dog’s Sex______Spayed or Neutered?______

Dog’s Breed______Dog’s Age______

Any kids in the household?______

Is your dog mouthy or does he nibble on you?______Is your dog house trained?______

Does your dog bark a lot?______

What brand of food does your dog eat?______

Does your dog take medications?______If so, for what?______How often?______

Does your dog have any past injuries or any current conditions? ______

Does your dog dig?______Is your dog frightened by any noises?______

Is your dog frightened around anything else?______

What happens when you or somebody else tries to take food or toys from your dog?______

Does your dog share well?______What kind of toys does your dog like?______

Does your dog get along well with other dogs?______

Does your dog prefer to play with any specific breed or size of dog? Male vs Female?______

Has your dog had obedience training?______What commands does your dog know?______

Would you be interested in taking obedience classes here at LHPR?______

Does your dog have a bathroom command? ______What is it? ______

Does your dog have any sensitive area’s on the body and where? ______

Where does your dog like to be petted?______Where?______

How does your dog react to strangers?______

Are there any types of people that your dog automatically dislikes or fears?______

How does your dog react to puppies?______

Rate your dog’s energy level, “1” being very mellow and “10” being a total uncontrollable spaz ______

Does your dog show any destructive behaviors when you aren’t at home? ______

Is your dog aggressive on leash? ______Off leash?______How often do you walk your dog on a leash?______

Does your dog jump up on you?______On others?______

Does your dog growl? ______Is it a play growl or a warning growl?______

Has your dog ever bitten anybody?______What were the circumstances? ______

Has your dog ever jumped or climbed over a fence?______How high was it?______

What were the circumstances? ______

Has your dog ever dug out of a fence?______

Vaccination Dates: DHLPP ______Rabies ______Bordetella ______Canine Influenza ______