About Your Family

All about you

Customer ID
Folder:
Full Name:
Address:
Area:
City/Town:
Post Code:
Email:
Mobile:
Phone Number:
Work:
Emergency contact:
Where did you hear about us:

About your family

Vet Clinic: / Vet Plus - 08008387587 / Taupo Vet - 3785433 / Vet Ora - 3765106
How many pets do you have:
Do you have children/other pets at home:
Have you owned dogs before, how many:
What age did you get your dog:
Where did you get your dog (breeders ,SPCA, Trade me, friends, Care
Have you been to puppy school/training:
What type of food does your dog eat (dry/wet, raw, brand)
How often do you feed your dog/how much:
Where does your dog sleep at home: / Dog Bed/Crate / On Your bed / In your room Kennel/outside

Pet Services:

Has your dog been away from you before:
Has Your dog stayed in a Kennels:
Have you used a day-care/pet minder service before:
Have you used a Dog wash/groomer before:
Has your dog had a bad experience with any of these:

What services are you interested in:

Doggie day-care / Regular 1x day week $23 / Casual $25 / Half Day $17
Dog walks / Dog wash / Full Grooming / Pet Taxi
Training / Puppy school / Pet Parties / Pet Supplies
Field trips / Pet sitting / Doggie Home Stay / Dog food

What Days Interested:

Monday / Tuesday / Wednesday / Thursday
Friday / Saturday / Sunday / Public Holidays

All about your Dog

Pet Name:
Breed:
Colour:
Sex: / Male Female
Age/Birth date:
Vaccinations: / Distemper/Hepatitis/Parainfluenza/Parvovirus / YES Date / NO
Bordatella (kennel Cough) / YES Date / NO
Lepto Virus: / YES Date / NO
Neutered: / YES / NO / Your Dog Must be done by 10mths old
Flea treatment: / Must Be done regular
Product Used:
Date worming: / Must Be done regular
Rego number: / microchip: / YES NO
Medical conditions:
Taking any Medication:
Allergies:
Recent/current Injuries:
Any restrictions on movement:

Dog Behaviour

Temperament
Energy
Where does your dog spend most of its days:
Is your dog allowed on furniture/bed when at home:
Number of walks per day/how long:
Type of location for walk (park,road,off on lead)
Does your dog walk on lead without pulling
Does your dog travel well in car
Do you use crate/seatbelt when in car

Has your dog ever:

Reacted negatively around food: Y/N / Escaped from your property: Y/N
Growled at people: Y/N / Bitten/Fight with a dog: Y/N
Bitten Someone: Y/N / Had complaints for barking Y/N

Is your dog anxious or frightened by any of the following:

Noises Y/N / Objects Y/N / People Y/N
Locations Y/N / Dogs Y/N / Men Y/N

Socialisation

How often does your dog socialize:
How does your dog react to other dogs on lead
How does your dog react to other dogs off lead
Any type of dog your dog automatically dislikes
What games does your dog enjoy with other dogs:
Will your dog willingly share food/eat near other dogs
Any type of dog your dog automatically prefer
What games does your dog dislike with other dogs
Does your dog share toys with other dogs
Does your dog like water/swimming

Does your dog get possessive/guard of any of the following?

Dogs / People / Toys/Objects / Food

Training

Has your dog/s attended formal training?
If Yes who with and what level:
Is your dog Housetrained
Lead Trained
Crate trained
Do you use/reward with treats:
Will your dog come when called
Commands they know:
Sit / Wait / Down / Up / Their Name / Quite
Come / Off / Wait / Stay / Leave / Stop