*Dog Name(s)

*Age

*Your Name

*Your Address

*City

*State

*Zip

*Phone Number

*Email

Other Number

How did you hear about us?

SCHEDULE:

Drop Off:
*Date: (Monday, Tuesday, Wednesday only)

Time: 8AM - Call Sherry @ 512-799-6084 if earlier/later drop-off time is required

GROOMING:

 Bath ($15) Anal Glands($10) Clip Nails ($10) Ear Treatment ($5) Full Grooming (all above) plus clip ($55) Dental Brush ($5) If your pet is matted or needs a complete shave please call ahead for special arrangements 512-799-6084

ACTIVITIES:

Select any special activities you would like your pet to receive while at Dream A Dream
 Walk 20 minutes ($15 per session), How often?
 Hike 20 minutes ($15 per session), How often?
 Swim 20 minutes ($15 per session), How often?
 Photo Session 20 minutes ($25)
 Training (Call for prices)
 Notes

Treats:
 C.E.T. Hextra Chews ($2 Each), How often?
 Beef Neck Bones ($3 Each), How often?
 Bully Sticks ($3 Each), How often?

In Case of Emergency Notify

Name

Phone Number

Please fill out the following information

Vet Name

Vet Phone Number

MEDICAL INFORMATION:

Please add vet records if you have them avaliable.

Current medications dog is taking and for what ailment:

What flea/tick preventive is your pet on

Check any that apply
 Allergies Arthritis Back Disorders Blindness Deafness Ear Infections Heart Disease Past Surgeries Seizures Other

Does your dog have any allergies? (medication, insects, ect.)

BEHAVIORAL INFORMATIONAL:

Does your dog respond to his/her name when called?
 Yes No

Is your dog house trained?
 Yes No

Does your dog urinate when approached?
 Yes No

Does your dog respond to owner's direction?
 Yes No

Does you dog engage in self mutilation?(chewing on leg/licking raw spots, ect.)
 No Yes

Has he/she been formally trained?
 Yes No

Has your dog ever bitten anyone?
 No Yes

Is your dog
 Kenneled at home Allowed to run free

Have you ever boarded your dog before?
 Yes No

In a stressful/new situation, check any of the following that describes how your dog reacts:
 Wildly Active Active Poised Assured Reserved Withdrawn/Lethargic

Does your dog climb/jump/chew through fencing of any type?
 No Yes

When your pet is around strangers does he/she
 Growl Hide Jump Bite Wet/Cower Other

Does your pet become unreasonably anxious when he/she is left alone?
 Yes No

Does your dog have any other behavioral characteristics we have not asked about?

Please write down a few things (good or bad) that you would like us to know about your best friend that will give us a better understanding for his/her care:

All dogs boarding at Dream A Dream must be current on all vaccinations including Rabies and Bordetella. Please bring current shot records to drop off. All dogs must be on a current flea/tick preventive.

Dream-A-Dream office will be closed on Thanksgiving Day, Christmas Day and New Years Day.

*By submitting this form you acknowledge and agree to our boarding contract. Please feel free to call or e-mail with any further questions you may have.