Application for Pet Sitting Services

APPLICATION FOR PET SITTING SERVICES

OWNER’S INFORMATION:

• Name:______

• Address:______

• City:______State:______Zip Code:______

• Place of Employment:______

• Work Phone:______Cell Phone:______Home Phone:______

• E-mail Address:______

• Emergency Contact Name (other than self):______

• Relationship:______

• Work Phone:______Cell Phone:______Home Phone:______

• Please List Other Persons Authorized to Pick Up Your Dog:______

• How Did You Hear About Doggie Lama?______

DOG’S INFORMATION (GENERAL):

• Dog’s Name: Breed:______

• Color:______Female: ____ Male: ____ Spayed/Neutered: Yes Ο No Ο

• Age: ______Birthday: ______Weight:______

• Type and Brand of Food:______

• Quantity and # of Times Fed Each Day:______

• Any Special Instructions for Feeding?______

• Can Your Dog Have Treats? Yes _____ No _____

• Has Your Dog Been Crate Trained? Yes _____ No _____

• What is your dog’s sleeping habits and behaviors:______

• How often does your dog need to pee and poop:______

DOG’S INFORMATION (HEALTH):

• Veterinary Clinic’s Name:______Address:______

• Veterinarian’s Name:______

• Phone:______Email:______

• Any Medical/Health Conditions, Injuries, or Allergies? Yes _____ No _____

If Yes, Please Describe:______

• Is Your Dog Currently Taking Any Medications? Yes _____ No _____

If Yes, Please Describe (include type, amount, times and any special instructions):______

• Does Your Dog Have Any Sensitive Areas on His/Her Body? Yes _____ No _____

If Yes, Please Describe:______

• Does Your Dog Currently Have a Problem With Fleas? Yes _____ No _____

If Yes, Please Describe:______

DOG’S INFORMATION (PERSONALITY & TEMPERMENT):

• Describe Your Dog’s Personality (mark all that apply):

Mellow/calm ______Shy/Submissive ______Playful ______High Energy ______

Dominant/Alpha ______Well Behaved ______Unruly ______

• Please Mark All That Apply to Your Dog:

Food Possessive:_____ Toy Possessive:___

Jumps Up On People:______Barks Excessively:___

Mouthy / Bites: Chews Excessively:___

Digs:_____ Separation Anxiety:___

Eats Feces:_____ Does Not Obey: ____

Eats Rocks:____ Fear of Loud Noises:____

High Strung:______Timid:____

Jumps Fences:____ Growls at Strangers:___

Destroys furniture: Destroys Toys/clothing:___

Other behavioral issues:

If Yes, Please Describe______

• Does Your Dog Socialize/Play With Other Dogs On a Regular Basis? Yes _____ No _____

If Yes, Please Describe:______

• Has Your Dog Ever Bitten A Person, Dog or Other Animal?

Yes _____ No _____

If Yes, Please Describe:

•Has Your Dog Ever Shown Aggressive Behavior Towards People?

Yes _____ No _____

If Yes, Please Describe:______

• Is Your Dog Ever Aggressive Around Other Dogs or Puppies? Yes _____ No _____

If Yes, Please Describe:______

• Are There Any Specific Types of People, Dogs, Animals or Situations That Your Dog Dislikes

or Fears? Yes _____ No _____

If Yes, Please Describe:______

• Is Your Dog Afraid of Any Specific Items, Noises or Situations? Yes _____ No _____

If Yes, Please Describe:______

• Is Your Dog an Escape Artist or Does Your Dog Like to Run Away? Yes _____ No _____

If Yes, Please Describe:______

•Is Your Dog a Rescue?______

If Yes, Please Provide History:______

• Anything Else We Should Know About?

To the best of my knowledge, the information that I have provided is both accurate

and true. I also acknowledge that I have read, understand and agree to abide by the

Policies and Procedures as outlined.

Owner’s Signature:______Date:______