Play Application

First Name

Last Name

Email

Phone

Dog's Name

Dog's Age

How Long Owned

Breed(s)

Does your dog have any physical disabilities? If yes, please explain disability and cause:

Does your dog have any medical conditions? If yes, please explain and if medication is used, please provide name and dosage.

Are there any types and/or breeds of dogs your dog seems to automatically fear or dislike? If yes, please describe:

How does your dog react to puppies?

How does your dog react to another dog approaching them in a park, at the beach, or on a walk? Please describe both on-leash and off-leash:

What kind of games does your dog play with other dogs?

What kind of games does your dog play with people?

Has your dog ever shared their food or toys with other animals? How do they react to another dog approaching their food or toys?

What does your dog do to show they are happy?

What does your dog do to show they are upset?

If yes, please describe :

Are there any particular types of people your dog seems to automatically fear or dislike?

Has your dog ever growled at anyone? If yes, what were the circumstances and how did you respond?

Has your dog ever bitten a person? If yes, what were the circumstances? Please describe the injuries if any:

Has your dog ever bitten an animal? If yes, what were the circumstances? Please describe the injuries if any:

Has your dog ever climbed/jumped a fence? If yes, what were the circumstances and how high was the fence?

Has your dog ever escaped from your house or yard? If yes, please explain the circumstances:

Has your dog ever chased or tried to chase a small animal? If yes, what were the circumstances?

Has your dog ever chased (or wanted to) anyone on a skateboard or bicycle? If yes, what were the circumstances?

Is your dog frightened by thunderstorms? If yes, describe typical behavior and what helps to relax or calm their fear:

Is your dog frightened or nervous around anything else? If yes, please explain:

Has your dog ever growled or snapped at a person who has taken food or toys away from them? If yes, what were the circumstances and how did you respond?

Has your dog ever growled or snapped at another dog who has taken food or toys away from them? If yes, what were the circumstances and how did you respond?

Other comments or information about your dog that you feel might be helpful:

Health History

Household Information

Dog Behavior Information