New Client Questionnaire

Name

Last name

Your Address

Your Email

Contact Number

Second / Emergency Contact Name

Second / Emergency Contact Email

Second / Emergency Contact Number

Any other regular visitors to home? e.g. cleaner, gardener, nanny

Days They Will Be At The Home

Any other animals in the home with special requirements. E.g. Cats not allowed outside or in?

Yes

No

Instructions

Any special instructions/ comments about the house?

Dog's Name

Age Now

Age Acquired

Breed

Gender

Are they spayed / nuetured?

Yes

No

At what age?

Early history / socialisation

Details of previous training

Please provide more detail if necessary

What motivates your dog? – toys? specific treats? praise?

Any health concerns?

Dietary Problems?

Medications

Old or recurring injuries

None

Vet Details

Are they microchipped?*

Yes

No

Insured?

Yes

No

Flea / Worming treatments used?

Dates of Vaccinations