The Greenish Dog

The Greenish Dog

Dog Information Form

Date: ____/ _____/ _____

Owner’s information:

Name: ______Phone Number(s) ______

Home Address: ______

Email Address:______

Veterinary’s Contact Information:

Name: ______Phone Number ______

Address: ______

General Health condition:______

______

Other services

All dogs whose stay is 7 days or longer will be returned bathed and brushed. (Unless otherwise instructed by the owner).

We will provide nail clipping service for an additional fee of $15

Dog Information:

Dog 1

Dog’s Name: ______Breed: ______

Size and Color ______Age of Dog: ______Gender ______

Valid Tag or License number ______

Has your dog shown aggression towards people or other animals? If yes please give details.

Does anything disturb, upset or unsettle your dog? If so please give details.

What has your experience been with dog walkers and boarders?

Health

Is your dog spayed or neutered? Yes or No

Annual Vaccination:

BordetellaYes or No

Rabies:Yes or NoTag Number______Prescription and Administering Veterinarian ______

Monthly Preventative Medications:

Parasitic idée/HeartwormYes or No

Flea and Tick medicationYes or No

Medication: If your dog is on medication please give details. (Purpose, Dosage, Frequency)

______

Diet: ______

______

Exercise regimen ______

Training

House trained:Yes or No

Socialized: ______

Basic cues: My dog will respond to the following cues under the following circumstances with this action:

All dogs must be properly socialized. A show of aggressionwill be cause for the immediate removal of the aggressor. All kennel charges will be the owner's responsibility and will be paid as additional fees.

Dog 2

Dog’s Name: ______Breed: ______

Size and Color ______Age of Dog: ______Gender ______

Valid Tag or License number ______

Has your dog shown aggression towards people or other animals? If yes please give details.

Does anything disturb, upset or unsettle your dog? If so please give details.

What has your experience been with dog walkers and boarders?

Health

Is your dog spayed or neutered? Yes or No

Annual Vaccination:

BordetellaYes or No

Rabies:Yes or NoTag Number______Prescription and Administering Veterinarian ______

Monthly Preventative Medications:

Parasitic idée/HeartwormYes or No

Flea and Tick medicationYes or No

Medication: If your dog is on medication please give details. (Purpose, Dosage, Frequency)

______

Diet: ______

Exercise regimen ______

Training

House trained:Yes or No

Socialized: ______

Basic cues: My dog will respond to the following cues under the following circumstances with this action:

All dogs must be properly socialized. A show of aggressionwill be cause for the immediate removal of the aggressor. All kennel charges will be the owner's responsibility and will be paid as additional fees.

Please check our website for the most current fee schedule and service menu