Client’s Name:* Date MM slash DD slash YYYY Phone*Email* Dog’s Name: Dog’s Age: Dog’s Breed: Date of Adoption: Is (dog’s name) spayed/ neutered intact? Most recent vet visit and results: Any current medical issues? Yes No Current on vaccinations? Current on Physical exam Rabies vaccine (rabies titers are NOT accepted) Distemper / parvo combination (or equivalent titer) Bordetella vaccine Canine influenza vaccines Leptospirosis vaccine Has your pet ever had any training? Yes No If so, when & for how long? Do you think it benefitted your pet? Are there any key words you use specifically for training that we can use while your pet is at daycare? How frequently do you plan on bringing your pet to daycare? All dogs will be required to pass a temperament test prior to admission to day care. Dogs must be current on heartworm and flea prevention. All dogs must be spayed or neutered. All Vaccines must be complete 2 weeks prior to entry to day care or boarding to ensure adequate immunity, If you are a LePar client, we will review your dog’s vaccine records and contact you if any updates are needed. If you are not a current LePar client, please email us records at daycare@leparvet.net or provide us with the name of the clinic where your dog last received it's vaccines and we will contact them If any updates are required, we will contact you Previous Daycare ExperienceI have a series of questions to help me gauge our ability to provide the most appropriate and enjoyable stay and environment for (dog’s name).Has (dog’s name) ever gone to daycare before? Yes No If yes:How did he respond? How did you feel about the experience? What lead you to look for a new daycare? If no:How do you expect (dog’s name) will respond to daycare? Do you have any concerns for (dog’s name) about attending daycare? Resource Guarding—Dogs Does (dog’s name) have any toys he prefers not to share with other dogs? Yes No If yes, which toys? How does (dog’s name) respond when another dog approaches where she’s resting? What about when another dog approaches you? Does that change if you have food or treats? How does (dog’s name) let other dogs know he doesn’t want to share? Resource Guarding—HumansDoes (dog’s name) have any toys he prefers not to share with humans? Yes No If yes, which toys? What does (dog’s name) do when a person reaches for something she has? How does (dog’s name) respond when a person approaches where she’s resting? What about when another person approaches you? Does that change if you have food or treats? How does (dog’s name) let people know he doesn’t want to share? Dog-Dog SocializationHow many dog friends does (dog’s name) have? Many A few One or two None How often does (dog’s name) have a chance to meet new dogs? Weekly Occasionally Rarely Would you say that (dog’s name) warms up to new dogs: quickly slowly upon first meeting over many meetings never Would you say that (dog’s name) is most comfortable: touching and interacting with other dogs being near but not interacting at a distance not at all What does (dog’s name) do when he meets a new dog for the first time? Has (dog’s name) ever had an altercation with another dog? Tell me what happened. Dog PlayWhat kind of dog does (dog’s name) prefer to play with? Big dogs Small dogs Mid-size dogs Older dogs Younger dogs Rowdy/ energetic dogs Laid back dogs Are there any kind of dog (dog’s name) dislikes or prefers not to play with? Big dogs Small dogs Mid-size dogs Older dogs Younger dogs Rowdy/ energetic dogs Laid back dogs Puppies Barrier FrustrationWhat does (dog’s name) do when she sees another dog while she’s on leash? What does (dog’s name) do when she sees another dog when she’s behind a fence or looking out through a window, such as at home or in the car? Dog- People RelationsWould you say that (dog’s name) warms up to new people: immediately quickly over time Is (dog’s name) comfortable having her collar put on and taken off? Loves it Tolerates it Hates it How can you tell? Is (dog’s name) comfortable having her leash put on and taken off? Loves it Tolerates it Hates it How can you tell? Is (dog’s name) comfortable being picked up, petted, and hugged? Loves it Tolerates it Hates it How can you tell? Has (dog’s name) ever had bitten or snapped at a person? No Yes Tell me what happened. CommentsThis field is for validation purposes and should be left unchanged.
