N29W23950 Schuett Dr. Pewaukee WI 53072 Phone: (262) 347-0787 Fax: (262)347-0780 www.pewaukeeveterinaryservice.com Owner/Pet Parent Name: Dog Day Care and Pet Boarding Guest Profile Client Information Last name First name Street Address City State Zip Home Phone Work Phone Ext. Cell phone EmailAddress Note: Pewaukee Veterinary Service & will not sell, release, or distribute any e-mail addresses. Owner/Pet Parent Name: Last name First name Street Address City State Zip Home Phone Work Phone Ext. Cell phone Email Address Note: Pewaukee Veterinary Service will not sell, release, or distribute any e-mail addresses. My Veterinarian: Dr. Veterinary Hospital of Record Address Phone Number 1
Dog Day Care and Pet Boarding Guest Profile Page 2 Alternate Emergency Contact(s) ~ (other than the client/pet parents): Emergency contact last name First name Emergency contact phone numbers: Home Phone Work Phone Cell Phone Please list the name (s) of those you authorize to drop-off and/or pick-up your pet from dog day care or boarding please note: we will only release your pet to the names you have listed below: How did you hear about us? I am interested in: O Dog Day Care O Boarding O Both Pet Guest: Pet Guest Information Pet Guest s Name Nickname(s) O Dog O Cat Primary Breed Color Sex: O Male O Female O Spayed O Neutered Approximate Weight **your dog must be spayed or neutered to participate in dog day care** Birthdate How long have you had this pet? This pet is from: O Breeder O Rescue O Stray O Store O Other Professional Training/Obedience/Education: O In-Home O Private Lessons O Group/Class O None Any specific concerns you have? 2
Dog Day Care and Pet Boarding Guest Profile Page 3 Pet Guest: Pet Guest s Name Nickname(s) O Dog O Cat Primary Breed Color Sex: O Male O Female O Spayed O Neutered Approximate Weight **your dog must be spayed or neutered to participate in dog day care** Birthdate How long have you had this pet? This pet is from: O Breeder O Rescue O Stray O Store O Other Professional Training/Obedience/Education: O In-Home O Private Lessons O Group/Class O None Has your pet(s) ever been boarded before? O Yes O No How was the experience? Any specific concerns you have? Has your dog(s) ever attended dog daycare before? O Yes O No How was the experience? Has your dog(s) ever been to the dog park? O Yes O No How was the experience? Is your dog(s) licensed? O Yes O No Dog license number 3
Dog Day Care and Pet Boarding Guest Profile Page 4 Medical Information: Does your pet have a current injury, health issue or medical condition? If yes, please explain: Does your pet have any health concern that requires special attention? If yes, please explain: Has your pet ever had any surgeries? If yes, please explain? Is your pet taking any medications? If yes, please name the medications and the reason: Does your pet have any restrictions on their activities or movements (i.e. due to hip dysplasia, sx, etc.)? If yes, please explain what they are: Is your pet on blood parasite/heartworm preventative? O Yes O No Is your pet on flea/tick preventative? O Yes O No Is your pet allergic to any medications, foods, or treats?? O Yes O No (we may use treats for positive reinforcement as needed) If yes, please explain the allergies and reactions: 4
Dog Day Care and Pet Boarding Guest Profile Page 5 Diet & Eating Habits: Pet Guest Preferences What food(s) are you feeding your pet? O Dry O Canned How much do you feed at each meal? How Often? O Once a day O Twice a day O Three Times a day Where does your pet typically sleep? O Pet bed O Floor O Crate O Furniture O Other Has your pet been eating, drinking, urinating, defecating as normal over this past week? O Yes O No, Please explain: Has your pet been acting normally over this past week? O Yes O No, Please explain: Pet Guest Personality Total number of people in your household Adult Males Adult Females Number of children Ages: Does your dog like children? O Yes O No Are there other animals in your household? If yes, please describe: Has your pet played with big dogs? O Yes O No In own household or in another setting? Has your pet played with little dogs? O Yes O No In own household or in another setting? Has your pet played with multiple dogs? O Yes O No In own household or in another setting? Has your pet ever bitten another dog? O Yes O No If Yes, what were the circumstances? Has your pet ever bitten another person? O Yes O No If Yes, what were the circumstances? Has your pet ever growled or snapped? O Yes O No If yes, what were the circumstances? 5
Dog Day Care and Pet Boarding Guest Profile Page 6 Pet Guest Personality Any repetitive or unusual behaviors you observe with your pet? O Yes O No Please explain: Does your dog act differently depending on where they are at i.e at home, out for a walk, at a dog park etc? Has your pet ever been crated? Yes O No O If Yes, how does your pet respond/react to being crated? My Pet(s): Enjoys Doesn t Like O O Having ears touched Any other information about your pet s likes & dislikes O O Having paws touched you feel is important for us to know? O O Having tail touched O O Having mouth touched O O Having nails trimmed O O Being touched while sleeping O O Being by other cats/dogs O O Being brushed O O Being hugged or petted O O Grabbing/holding collar Personality Is Tends To Behaves O Playful/Outgoing O Afraid of thunder/noises O Perfectly O Timid/Shy O House broken/potty trained O Shakes or trembles O Assertive/Pushy O Litter/paper trained O Walks or moves away O Independent O Protective O Growls O Verbally sensitive O Mouthy O Snaps O Affectionate O Afraid of men or women O Shows teeth O Excitable O A digger O May bite O Aggressive O A fence climber O Will bite O A jumper O Toy/food possessive O Separation anxiety O Chew a lot! 6
Dog Day Care and Pet Boarding Guest Profile Page 7 My Pet knows these commands as verbal cues: Pet Guest Personality O Sit O Down O Stay O Come/Here/Front O Off O OK O Go Potty O Leave It O Easy/Settle/Relax O Inside /Outside O Quiet Do you reward your pet after you give these commands? If so, what do you use as a reward? When your dog has to go to the bathroom he/she will : O Bark O Whine O Sit by the door O Pace back & forth O Other How does your dog behave if he/she should become stressed? Are you able to remove toys or items from your dog s mouth? O Yes O No What is your dog s favorite toy to play with? Additional information you would like us to know about your pet(s): Please Note: Our receipt of all pet guest profiles is required prior to dog day care and/or boarding reservation check-in. Please mail, fax or better yet stop in and give your profile to us in person! Tours always welcome. Look for our on-line guest profiles and e-mail delivery options in the future. 7