A Pet’s Palace Inc. Application and Pet Personality Profile
Owners Information
Name______
Address______City______State ______Zip Code ______
Home Phone______Work ______Cell ______Email______
Pet Information
Name______Breed ______Male/Female DOB/Age ______
Spayed/Neutered? Y/N At what age? _____ What is your Flea/Tick protection ______
Veterinarian
Clinic ______Veterinarian ______
Address ______City ______State _____ Zip Code______Phone _____
Emergency Contact
Name ______Relationship ______Phone Home______Cell______
If you are unable to be reached is this person authorized to make decisions regarding your dog? Y/N
General
How long have you owned your dog(s)? _____ Has your dog ever been borded or attended dayplay? Y/N
How did they respond? ______
Household
What other animals are in your home? ______How do they interact with your dog? ______
Has your doghad experience sharing? Toys ______Food ______Attention ______Is your dog
left alone at home? Y/N How long? ______Is your dog crate trained? Y/N Has your dogever been
destructive in your home? Y/N How many walks does your dog take each day and what times? ______
Health
Are there any current or chronic medical problems? ______
Does your dog have any hip/joint problems or existing injuries? Y/N If yes, any restrictions? ______
Is your dog taking any medication required during their stay? Y/N Original containers only!
Does your dog have any allergies or food sensitivities? Y/N If yes ______
Describe your dog daily meals. Food ______Quantity ______Times ______
Behavior
Has your dogever bitten a person or another dog? Y/N Explain ______
Does your dog ever bark or growl at people or dogs? Y/N Explain ______
Has your dog ever been attacked by another dog? Y/N Explain ______
Does your dog have regular interaction with other dogs? Y/N Explain ______
Describe your dog’s behavior? Dominant/Submissive Is your dog afraid of any breed? Y/N ______
Is your dog frightened or nervous of anything? ______Has your dog ever growled or snapped while taking food or toys away? Y/N Is your dog an escape artist or have a history of breaking out? Y/N Explain______
Fun Stuff
How does your dog show they are happy? ______Do they have a favorite game or activity? ______Does your dog have a favorite treat? ______
Does your dog a have a favorite area to be rubbed or scratched? ______Are any areas off limits? ______Is your dog allowed on the furniture at home? Y/N Does your dog have any restrictions while visiting us? Activity level, group play, treats, other.______
Is there any behavior you would like us to encourage or discourage? ______
Is there anything else we should know about your dog? ______
How did you choose A Pet’s Palace? Recommendation______Veterinarian______
Advertisement______Internet______
Other ______