General Information

Your Name:     Your Email Address: 

Street Address:    City, State, Zip: 

Home Phone:    Office Phone:    Cell Phone:

Emergency Contact Name & Phone: 

Your Vet's Name & Phone: 

Names of all individuals allowed to pick up your dog: 

Your Dog's Information--If more than one dog, please submit additional forms.

Name:    Breed: 

DOB:  Sex:  Weight:  Color: 

Age at which your dog was spayed/neutered: 

Has your dog ever bitten or shown aggression toward another animal or person: 

Has your dog ever been attacked by another dog or abused by a person:    

Does your dog have any peculiar fears or dislikes (i.e. noises, objects, people): 

Has your dog played with other dogs:    Has your dog jumped fences: 

Has your dog been in any obedience/training classes:    What commands/tricks does your dog know: 

Has your dog been to a daycare:  Yes No 

                             a dog park:  Yes  No

What kind of toys does your dog enjoy: 

Does your dog have any sensitive areas: 

Does your dog have any restrictions while visiting us (i.e. activity level, no treats): 

Does your dog have any health problems:    Is your dog on medication: 

Is your dog allergic to anything:   

Does you dog need to be fed while at daycare:   

Is your dog on FRONTLINE? (Required prior to interview).  Yes No 

*Would you like Dogma to request your dog's health information (see Health Certification) from your Vet for you?  Yes No

How did you hear about Dogma? 

Please add any additional information that would be important for us to know: 

Dogma holds the health and safety of all dogs in our care paramount.  Thus, we require a certification of health. Upon your authorization (above), we will request a completed health certification directly from your veterinarian.*  Thank you so much for enrolling with us, today!  We look forward to having you and your dog become a part of the Dogma family!

*If you would prefer to obtain your dog's health certification, instead of having Dogma do it for you, please check "No" above, and submit the health certification form directly to your veterinarian.

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                                                   Tucson, Arizona Dog Daycare & Grooming

                                                                      © 2005 Dogma, LLC. All Rights Reserved.