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Intake Form
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Back
West Linn Forms
Reservations
Intake Form
Safe & Hound Rules
Daycare Agreement
Vaccination Records
Grooming Intake Form
Printable Forms
HOME
About
Services & Times
Wilsonville Services
West Linn Services
Rates
Wilsonville Rates
West Linn Rates
Contact
Wilsonville Forms
Wilsonville Forms
Reservations
Intake Form
Vaccination Records
Daycare Agreement
Safe & Hound Rules
Printable Forms
West Linn Forms
West Linn Forms
Reservations
Intake Form
Safe & Hound Rules
Daycare Agreement
Vaccination Records
Grooming Intake Form
Printable Forms
Wilsonville Intake Form
Parent Profile
Name
*
First Name
Last Name
Additional Parent Name
First Name
Last Name
Cell/Contact Phone
*
(###)
###
####
Emergency Contact
*
Emergency Contact Phone
*
(###)
###
####
Address
*
Email
Ok to send emails?
Yes
No
Who else is authorized to pick up your dog?
*
How did you hear about us?
Referred by:
Dog Information
Dog's Name
*
Breed
*
Birthdate
*
MM
DD
YYYY
Gender
*
Male
Female
Weight
*
Color
*
Spayed/Neutered?
*
Yes
No
If not yet Spayed/Neutered, when?
How long has your dog been in your family?
*
Where did you get your dog (shelter, breeder, etc.)?
*
Tell us about your dog’s health
Veterinarian:
*
Veterinarian Phone:
*
List any allergies:
Describe any medical conditions:
List any physical limitations (blind, deaf, missing ear, etc.)
Has your dog been ill in the last 30 days (please explain)?
Has your dog had surgery in the last year?
Type and brand of food:
*
How much per feeding and how often per day?
*
At feeding time does your dog eat...
*
Fast
Slow
Can your dog have treats?
*
Yes
No
Temperament and History:
Has your dog ever been to daycare or boarding?
*
Yes
No
If yes, where have they gone?
Does your dog go to the dog park?
*
Yes
No
Has your dog had obedience training?
*
Yes
No
What commands does your dog know?
*
Has your dog ever climbed or jumped a fence?
*
Yes
No
Is your dog crate trained?
*
Yes
No
Does your dog chew on his bedding?
*
Yes
No
Only when anxious
Please describe any behavioral problems you might know of and let us know if there is anything you want us to be aware of:
*
*
I acknowledge that my dog must be up to date on their vaccines and proof from my vet needs to be emailed to: info@safeandhound.net before my dog’s Evaluation Day can be scheduled
*
I have read and agree to the Safe & Hound Daycare Agreement
I have read and agree to the Safe & Hound Rules
Daycare Agreement
Safe & Hound Rules
Thank you!
