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To print this form, you may select the text (beginning at Dog Information Sheet and continuing to the end of the last line). Once text is selected, go to File (top left of your browser screen) and select print. When the print box is open, click the option that says Print Selection. From my computer and using Microsoft's Internet Explorer, this prints as a two-page form. One form will need to be filled out for each dog that will be under the care of a Coddled Critters In Home Pet Service Provider.
Coddled Critters In Home Pet Services
281-728-9001 * firstname.lastname@example.org
BONDED AND INSURED
Member PSI, HAPPSA & NAPPS
DOG INFORMATION SHEET
Client Name: _________________________
Dog's Name: _______________ Weight ___
Breed ______________ Color _____________
Sex: M F Altered: Y N
Age _______ Birthday___________
Is your dog Current on ALL Shots? Yes No
If not please explain:
Does your dog have and wear a collar with rabies tag attached? Yes No
Rabies Tag Number:
Specific feeding instructions:
Recycle Empty Cans? Where? Remove Paper on cans?
Where to put dirty plastic bags?
Treats? Where are they kept and How many?
Are bites of people food allowed? Favorite foods?
Are there any current diseases, illnesses or disabilities? Yes No
If yes, please give pets name and description of problem
Does your dog need medications administered? YES NO
Describe any medication procedures and the name and dosage of the medication as well as where it is kept.
Special cleaning instructions for any accidents & location of supplies:
Does your dog have a special hiding place or places?
Is there something that will bring your dog out of hiding (the sound of the can opener or treat jar, for example)?
Does your dog have a favorite game, toy or words?
Where do you keep your collar and leash?
Does your dog need a special harness or choke collar for walks?
Please answer the following brief questionnaire about your dog. It will help us to better care for him/her:
• Is friendly with other dogs YES / NO
• Likes new adults YES / NO
• Likes children YES / NO
• Tries to escape? YES / NO
• Will eat when stressed? YES / NO
• Fearful of loud noises? YES / NO
• Likes to be petted? YES / NO
• Likes to be held? YES / NO
• Skittish with strangers? YES / NO
• Must stay on leash during walks YES / NO
• Is allowed in the house YES / NO
• Is allowed on the furniture YES / NO
• Is allowed to have treats YES / NO
• Is prone to digging YES / NO
• Is prone to chewing YES / NO
• Is fearful of noises or other things YES / NO
• Obeys basic commands YES / NO
• Has bitten people or other dogs YES / NO
• Has shown other aggression YES / NO
Please indicate anything else about your dog's habits or behavior that would be useful to us in providing care: