Contact/Applicant Info

Today's Date:

Owner's Name:

Address:

City, State, Zip:

Home Phone:

Cell phone/pager:

Employer:

Work Phone:

Email Address:

Are you applying for dog daycare?

Are you applying for overnight boarding?

Are you applying for class?

Please list which classes you are applying for:
Puppy Socialization Parties
Puppy Kindergarten
Advanced Puppy Kindergarten
Adolescent Dog Obedience
AKC Canine Good Citizen
Please put "none" if you are not applying for classes.

Are you applying for grooming?

Are you applying for a private behavior consultation?

Emergency Contact Name & Phone:
(who we can call if you cannot be reached)

Number of adults & number of children in household:

Number/species & ages of other pets in household:

Your Dog's Info

Dog's Name:

Date of Birth (with Year):

Breed:

Sex:

How old was the dog when you got them?

How old was the dog when they were spayed/neutered?

Medical/Nutritional Info

Veterinarian/Clinic:

Phone number and/or address:

Please list any medical conditions:

Dietary limitations/allergies:

Training & Temperament History
(Skip this section if dog is under 12 weeks old)

What training has this dog had (list name of trainer)?

Rate your dog's accomplishment level on the following areas:
(1 = worst, 5 = best)

Sit Stay Come Heel

Has this dog ever bitten any dog or human?

If yes, how many times and under what circumstances? (If not, put "n/a")

List any problem behavior:
(ex. jumping, shyness, playbiting, fear, separation anxiety, aggression, etc.)

Rate your dog's comfort level/overall behavior under the following condition:
(1 = worst, 5 = best)

With familiar adults
With unfamiliar adults
With familiar children
With unfamiliar children
With familiar dogs
With unfamiliar dogs
With other animals (cats, ferrets, squirrels, etc.)

How did you hear about Dog DaysT of Buffalo?

See an
excerpt of
Positive Puppy
Training:
Bite Inhibition