New Client Intake Form Customer Name* First Last Customer Email* How did you hear about us?* Social Media Existing Customer Referral Driving By Google Search Apartment Complex Other Other Name of Apartment Complex Furry Family Member Basic Information* Dog Name Dog Age (>4mo) What services are you interested in? (click all that apply)* Select All Daycare Boarding Grooming Training Is your dog Spayed/Neutered?* Yes No Is your dog up to date on the following vaccinations (select all that apply)?*Note: A current vaccination record from your Vet is required Select All Rabies Bordetella DHPP Notes on vaccination informationAre there any medical situations we should be made aware of? (ie. allergies; skin ailments; digestive ailments; diabetes; etc.)* Yes No If Yes, which one(s)?Is your dog currently on any medications?* Yes No If Yes, which one(s)?Behavioral and Social InteractionsHas dog attended daycare before?* Yes No Other (explain) If Yes, which one(s)?Has dog ever been dismissed from daycare/boarding? If yes, explain* Yes No Other (explain) If Yes, please describe.Has your dog socialized large group of dogs (8+)?* Yes No Other (explain) If Yes, please describe.How does your dog behave with new dogs?* No Issues Sometimes Issues Constant Struggle If any issues, please describe.Has your dog ever growled at or bit a PERSON?* Yes No If Yes, how many times? What was the injury? Did it happen at a daycare?Has your dog ever growled at or bit another DOG?* Yes No If Yes, how many times? What was the injury? Did it happen at a daycare?Can you take food items away from your dog without growling?* Yes No If No, please describe.Has your dog ever displayed resource guarding behavior with other dogs or people?* Yes No If yes, please describe.Has your dog ever jumped a fence or barrier?* Yes No Not Sure If Yes, please describe.Any additional notes or concerns?BHV Location*AirportBuckhead (Pharr Rd.)Cheshire Bridge (Village)DecaturLambert Drive (Inn)Marietta (East Cobb)North Ave. (Lofts)
