New Customer Form

Please fill out the form below, submitting one form for each dog in your family. All fields are required.
If submitting this form on a weekend, please allow extra time for processing.  We will enter your
information into our database and contact you as soon as possible to set up an evaluation day for your pet(s).

OWNER & DOG INFORMATION
Owner First Name
Owner Last Name
Dog's Name
Breed
Weight
Sex	Male   Female	Neutered? Yes    No Dog's must be spayed/neutered if over the age of 6 months.
Color/Description
DOB (if unsure, please estimate):	(MM/DD/YYYY)
Vet/Clinic Name
Vet/Clinic Phone Number
What Type of service are you interested in?	Boarding   Training   Daycare
CONTACT INFORMATION
Home Address
City
State
Zip Code
Home Phone
Work Phone
Cellular Phone
Alternate Phone Number(s)
Email
Emergency Contact Name
Emergency Contact Phone
How did you hear about DogBoy's?	--Select One-- Vet News Article Advertisement Local Event Website Friend DogBoy's Customer/Employee Other If other, please specify:
GENERAL INFORMATION ABOUT YOUR DOG
How old was your dog when you got him/her? (if unsure, please estimate)
How and/or where did you get your dog?
What was your primary reason for getting a dog?	Companion   Protection   Gift   To Breed   For Child   For Other Dog   Replace Previous Dog
Is your dog a (check all that apply):	Digger   Chewer/Shredder   Barker   Fence Climber If fence climber, list type of fence and height
Does your dog exhibit any destructive chewing?	Yes     No
If yes, check all that apply:	Impersonal items: Furniture   Flooring   Doors Other Personal items: Socks   Underwear   Clothing   Shoes Other
Is your dog sound or sight sensitive (check all that apply):	Thunderstorm   Lightening   Firecrackers Other
Likes to play with (check all that apply):	Women   Female Dog   Men   Male Dog
Is your dog (check all that apply):	Dog Aggressive     Human Aggressive Please explain:
Has your dog ever bitten anyone?	Dog   Adult   Child
Did he/she break skin?	Yes    No Please explain:
Favorite Games w/Family/Owner (check all that apply):	Tug/Fetch   Chase   Wrestle   Hide & Seek   Walks
Where are toys kept?	Toy Box   Throughout House   Out of Reach   Yard
Favorite Toys
Favorite Treats
Spends % of time in-doors and % of time outdoors
Where does your dog sleep? (check all that apply):	Owner's Bed   Bedroom   Sofa   Living Room Floor Kitchen   Outside Other
Is your dog house-trained?	Yes    No
How does dog react to crate?	Love   Tolerate   Hate   Destroy
On a scale of 1-5, how easy is it to groom your dog (ie - Bath, clip, brush)?	Easy ----------------------------------Difficult 1     2     3     4     5
What BRAND of dog food do you feed (main meals)?
Check any additional items your dog consumes:	Dog Treats    Cat Treats    Table Scraps    Bones Cat Food    Feces    Other
Check feeding habits:	Free feed   Three times a day   Twice a day   Once a day
Does your dog have any allergies?	Yes    No If yes, specify:
Is your dog taking any medications?	Yes    No If yes, specify:
Has your dog ever had seizures?	First Last Medications
How do you control/correct misbehavior (check all that apply)?	Shock collar   Choke/prong collar   Time out   Alpha Roll   Newspaper/Magazine Verbal (explain)
Please list behavior problems and/or goals for your dog:
Special Instructions
I have read and agree to the Rules of the Game (By selecting the check box above, you are giving your online signature that the statement is true and correct) Today's Date (MM/DD/YYYY)