Desert Pups Information Form OWNER INFORMATION How Did You Hear About Us? * Owner's Name * First Name Last Name Email * Cell Number * (###) ### #### Home/Work Number (###) ### #### Home Address Address 1 Address 2 City State/Province Zip/Postal Code Country Co-Owner's Name If applicable First Name Last Name Co-Owner's Number If Applicable (###) ### #### EMERGENCY CONTACTS Emergency Contact's Name First Name Last Name Emergency Contact's Number (###) ### #### Relationship Veterinarian Clinic Clinic Phone Number (###) ### #### Veterinarian Clinic Address Address 1 Address 2 City State/Province Zip/Postal Code Country DOG INFORMATION Multiple dogs in household: please fill out one form per dog. Service Requested * Daycare Boarding Dog's Name Dog's Birthday MM DD YYYY Sex Male Female Weight Breed Color/Markings Fixed? Neutered/Spayed None Anticipated Date of Getting Fixed All dogs must be altered at Desert Pups MM DD YYYY Vaccinations DHPP Rabies Bordatella (Kennel Cough) Flea & Tick Treatment Expiration Date for Vaccinations Known Health Conditions BEHAVIOR & TEMPERAMENT Potty inside, outside, both? Usual potty times throughout the day Favorite Activities Social Temperament Dog Friendly Dog Reactive People Friendly People Reactive Additional information regarding dog's behavior and temperament i.e. dislikes men, people wearing hats, certain breeds, etc. FEEDING INFORMATION Meal Schedule Amount of Daily Food Does your dog need medication? If yes, please fill out Medication Administration Form Yes No Food allergies, restrictions, or sensitivities Additional information regarding dog's feeding Thank you!
