RUFF 'N READY® Online Intake Form

* Required fields
Name *
E-mail Address *
Address *
City, State, Zip *
Home Phone *
Cell Phone *
Your Occupation
Work Phone *
How did you hear about us?
Is this inquiry for daycare, boarding, both
If daycare how many days per week
Emergency Contact Name
Emergency Contact Phone Number
Dogs Name
Breed (if mixed-list breed mix. example: maltese/poodle)
On a scale from 1-10 (1-poor 10 great) how social is your dog towards other dogs?
On a scale from 1-10 (1-poor 10-great) how social is your dog to people?
Gender
Date spay/neutered
Birthdate
Weight
Microchip # (if any)
Microchip Recovery Agency/Phone Number ie: Home Again, etc
Vet Clinic and Dr's Name
Vet Address
Vet Phone Number
Known Allergies
Medications
	Please Check ALL That Apply
	Dog Agressive
	Stool Eater
	Runs Away
	People Aggressive
	Fence Jumper
	Barks A Lot
	Toy Aggressive
	Food Agressive
	Seperation Anxiety
	High Energy
	Escape Artist
	Picky Eater
	Chews
	Shy
	Jumps On People
	Marks (Urinates)
	Leashed Neighborhood walks OK? (check if ok)
	Off Leash FENCED IN Dog Park OK? (check if ok)
Where Did You Get Your Dog?
When Did You Get This Dog?
Has Your Dog Had Professional Training?
If So, By Whom, What Was The Training For?
Comand's Mastered
Where Does Your Dog Sleep?
What Form's Of Correction Do You Use?
Has Your Dog Ever Bitten Another Dog/Person
What Causes Your Dog To Snap At Others?
Is Your Pet Fully Housebroken?
Does Your Dog Know How To Use A Dog Door?
Info on what you'd like us to know about your pet
What flea product do you use?
Requested boarding dates Date IN/ Date HOME

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