New Starter Questionnaire

Name

Phone Number

Email Address

Address line 1

Address Line 2

city

Post Code

Dogs Name

Dog's Age

Dog's Gender

Dog's Breed

Is your dog microchipped? Is your dog microchipped? Yes No

What is the microchip Number?

Is your dog Neutered / Spayed Is your dog Neutered / Spayed Yes No

Up to date on Shots? Up to date on Shots? Yes No

Please provide details if your dog is anxious around, or frightened by, any of the following: Please provide details if your dog is anxious around, or frightened by, any of the following: Noises Actions Objects Other Dogs People Children Livestock Bikes Cars

Please specify if any selected

Does your dog have a specific command to "Go to the bathroom"?

Has your dog ever bitten someone? Has your dog ever bitten someone? Yes No

What were the circumstances?

Has your dog ever bitten another dog, other than play-biting? Has your dog ever bitten another dog, other than play-biting? Yes No

What were the circumstances

Does your dog allow you to take things out of his/her mouth? Does your dog allow you to take things out of his/her mouth? Yes No

Please give any other information that you think would be useful to enable us to give your dog the best possible care while under the care of Red Dog Pet Services

Vet Name

Vet Phone Number

Vet Street Address

Vet Address Line 2

Vet City

Vet Post Code