Dog's Name
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Parent(s) Name(s)
*
Please separate names by using a comma.
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Cell Phone
*
(###)
###
####
Home Phone
(###)
###
####
Email
*
Veterinarian
*
Breed
*
Estimated Age/Date of Birth
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Color
*
Sex
*
Is your dog spayed/neutered?
*
Describe any medical/health issues we need to be aware of (i.e. seizures, heart/orthopedic problems, chronic pain, etc.):
How long has your dog been in your family?
*
Emergency Contact (other than yourself or your spouse)
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First Name
Last Name
Emergency Contact's Phone Number
*
(###)
###
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How did you hear about St. Hubert's DDC?
*
If referred by a current camper please tell us who so we can thank them!
How often do you intend to utilize daycare?
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What day(s) of the week were you most interested in?
*
What service(s) are you most interested in?
*
Why are you interested in DDC for your dog?
*
Has your dog ever been enrolled in daycare before?
*
If yes, where:
If yes, how did your dog behave with the other dogs?
If yes, how did your dog behave with the staff?
Have you and your dog participated in any kind of obedience training?
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If so, where?
How does your dog react if people or other dogs try to remove their toys or food?
How does your dog react if another dog invades their space (gets really close to them/shares a bed) or you pet another dog while petting them?
How does your dog react to being led by the collar?
How does your dog react when put in a crate?
Does your dog ever continue to bark for long periods of time?
If yes, please describe:
Has your dog ever bitten another dog or person and drawn blood?
If yes, please explain:
Has your dog ever climbed a fence?
If yes, how high was it and what type of fence?
How often does your dog socialize with other dogs?
Where do you take your dog to socialize (examples: dog parks, other daycares, training classes, casual walks greeting other dogs on a leash, etc.)?
Does your dog display any anxiety or aggression towards people or other dogs?
If yes, please explain:
Describe any behavioral problems/idiosyncrasies/special sensitivities we should be aware of:
