"*" indicates required fields Date* MM slash DD slash YYYY Owner's Name* First Last Phone*Email* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Emergency ContactNamePhone NumberHow did you hear about us?* Dog information Please submit one application for each dog who will be visiting us Dog's Name* Breed* If a mix, list two predominant breeds in behaviorDate of Birth* MM slash DD slash YYYY Color Weight Gender Male Female Is your dog Spayed or Neuter?* Yes No (We do require any dogs visiting/staying with us over the age of 9 months be altered) Grooming and Medical InformationName of veterinarian so we can call for vaccines*NameCityDoes your dog have any food allergies?* Yes No If yes, please list*Does your dogs have any treat restrictions?* Yes No If yes, please list*What is your dog’s favorite treat?* Does your dog have any physical disabilities, medical conditions, or chemical/scent sensitivities?* Yes No If yes, please explain*Has your dog ever been groomed before?* Yes No If yes, when was the last groom* Does your dog have any sensitive areas on his/her body?* Yes No If yes, where?* Do you use any grooming tools at home (brushes, rakes, clippers, nail grinder etc.)?* Yes No If yes, what?*What behavior does your dog exhibit when nervous or stressed?*What do you do at home to help your dog when nervous or stressed?We strive to be a fear free facility. This means we take the time to get to know you dog and take steps to help reduce fear, stress, and anxiety. This also mean that if you dog shows excessive fear or stress over a procedure, we will not use harsh restraint or ‘force’ them to tolerate a procedure. We may ask you to consult with your veterinarian for anxiety medication or charge a fee if your pet requires additional time to reduce fear, anxiety, or stress.CommentsThis field is for validation purposes and should be left unchanged.
