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Muddy Paws Dog Boarding and Obedience School
Dog Boarding Questionnaire
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* Indicates required question
Owner Name
*
Your answer
Address (street, city, state, zip)
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Pet Name
*
Your answer
Pet's Date of Birth
*
MM
/
DD
/
YYYY
Weight
*
Your answer
Sex
*
Female
Male
Spayed/Neutered
*
Yes
No
Breed
*
Your answer
Color/markings
*
Your answer
Veterinarian Name
*
Your answer
Veterinarian Address (street, city, state, zip)
*
Your answer
Veterinarian Phone
*
Your answer
Veterinarian Email
Your answer
Has your pet ever stayed at a boarding/daycare facility before?
*
Yes
No
If yes, reason for leaving that facility?
*
Your answer
Is your pet friendly toward people?
*
Yes
No
Other:
Is your pet friendly with other animals (cats, dogs, horses, etc)?
*
Yes
No
Other:
Has your pet shown ANY signs of aggression toward a person or animal?
*
Yes
No
Describe the aggression (if applicable)
*
Your answer
Does your pet resource guard? Can you take away toys or treats without growling or aggression?
*
Yes, and I'm working on resource guarding issues
No, my pet hasn't demonstrated resource guarding issues
Other:
Are there any situations your pet is uncomfortable with (touching certain areas of their body, grasping their collar, being picked up, umbrellas, thunderstorms, fireworks, etc)?
*
Your answer
If yes, how does your pet react? Are there any remedies that will calm their reaction?
*
Your answer
Does your pet have a favorite toy or like to play fetch?
Your answer
Has your pet EVER had a heat injury?
*
Yes
No
Maybe
Does your pet have any of the following medical conditions?
*
Heartworm disease
Heart murmur
Tumors
Epilepsy/seizures
Skin allergies
Environmental allergies
Thyroid disease
Arthritis
Hip dysplasia
Cancer
Sensitive stomach
Chronic eye or ear infections
None
Required
Does your pet have ANY physical limitations (recovering from surgery, heartworm positive, previous injuries, etc)?
*
Your answer
Does your pet have any of the following behavioral issues?
Mouthiness
Food aggression
Excessive barking
Ingesting items (rocks, feces, toys)
None
Other:
Does your pet have any fixations, obsessions, or phobias of the following items?
Balls/toys
Cats/squirrels
Digging
Jumping fences
What is your pet's energy level?
*
Mellow, lays around
1
2
3
4
5
Energizer bunny
What type of food and how much do you feed your pet (ex. 1 cup twice daily Purina Pro Plan Adult)?
*
Your answer
Is your pet on any medications?
*
Yes
No
If yes, please provide medication list and instructions
*
Your answer
Is there anything else you feel we should know about your dog?
Your answer
How did you hear about us?
*
Facebook group
Google search
Referral
Other:
If referred, who referred you to us?
*
Your answer
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