Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Mobile phone:
*
(###)
###
####
OK to text you to communicate about scheduling and during an emergency?
*
Yes
No
Home phone:
*
(###)
###
####
Name of Pet(s)
*
How did you hear about us?
*
What are your main goals for attending Camp Wagalot?
*
Gender
*
Female--altered
Male--altered
Female-intact
Male-intact
Age
*
Birthday
MM
DD
YYYY
Breed
*
Color
*
Weight
*
Microchip
*
Yes
No
Microchip brand
Microchip #
Name of Vet
*
Vet's Address
*
Vet's Phone Number
*
(###)
###
####
Feeding schedule (times of day, amount)
*
Dog food brand and type (kibble, canned)
*
Does your dog have any dietary restrictions?
*
Is your dog allowed to have treats?
*
Yes
No
Is your dog food motivated?
*
Yes
No
Where did you get this dog?
*
How long have you had him/her?
*
If you have not had the dog since puppyhood, what do you know of her/his prior history?
*
Are there other pets in the household?
*
Yes
No
Please list your other pets' species, breeds and ages.
Does your dog like to travel in the car?
*
Please describe your dog's overall temperament.
*
Does your dog have any areas on her/his body that s/he does not like to be touched?
*
Yes
No
Please describe:
Does your dog have a special place that he/she likes to be petted or rubbed?
*
Yes
No
Please describe:
Please list your dog's hobbies and favorite activities:
*
How does your dog react to other dogs (in general)?
*
How does your dog react to other dogs (inside your home?)
*
How does your dog react to other dogs (out in public?)
*
How does your dog react to strangers?
*
Are there any kinds of people s/he automatically fears or dislikes?
*
Yes
No
Please describe:
Are there any kinds of dog(s) that your dog tends to fear or dislike?
*
Yes
No
Please describe:
Has your dog ever been in a situation in which s/he felt the need to bite or fight with another dog?
*
Yes
No
Please describe:
Has your dog ever been in a situation during which your dog felt the need to bite a person?
*
Yes
No
Please describe:
Has your dog ever escaped or attempted to escape by digging, jumping or climbing fences?
*
Yes
No
Please describe:
Does your dog jump on people?
*
Yes
No
Please describe:
It is important for us to know the level of exercise that your dog is used to. What kinds of exercise does your dog receive?
*
Please check all that apply.
What kinds of exercise does your dog prefer?
*
Please check all that apply.
How often?
Distance or duration?
What known behavioral challenges does your dog have?
Is there a circumstance or situation that scares your dog?
*
Yes
No
Please describe:
Is your dog housebroken?
*
Yes
No
Where does your dog sleep?
*
Is your dog crate trained?
*
Yes
No
Do your dog play with toys?
*
Yes
No
What kind?
*
If other, please describe:
Have you known your dog to be toy- or food-possessive?
*
Yes
No
Please describe:
Has your dog gone to daycare?
*
Yes
No
If there were any problems, please describe:
Have you ever boarded your dog?
*
Yes
No
Please describe what you like and disliked about the experience.
Has your dog received or is s/he receiving formal training?
*
Yes
No
If so, where and when?
Were you happy with the trainer and the outcome?
Yes
No
Please describe:
What commands does your dog know?
*
Please check all that apply.
Does your dog know any other commands?
Where does your dog stay when you leave home?
*
If other, please describe:
Are there any other training areas that you would like us to focus on?
Does your dog get regular grooming?
*
Yes
No
Which groomer do you recommend?
Does your dog like to receive brushings?
*
Yes
No
How does s/he like to be bathed?
*
How does your dog react to getting his/her nails trimmed?
*
Does your dog have any health concerns that you are aware of?
*
Yes
No
Please check all that apply:
If other, please describe:
Does your dog have any medical restrictions on his/her activities?
Yes
No
Please check all that apply:
If other, please describe:
Is your dog currently on any medication?
*
Yes
No
If yes, please describe:
Does your dog have any allergies?
*
Yes
No
If yes, please describe:
Does your dog receive flea and tick preventative?
*
Yes
No
Brand
Type
Frequency
Is there anything else you would like us to know about your dog?
When would you like to start?
