Application Form

Fill out this form and then give us a call at 410-539-7626 to schedule your evaluation!

    Dog's Information







    Male/Female

    MaleFemale

    Spayed/Neutered

    YesNo

    Pet Parent Information











    Veterinarian Information





    Proof of Required Vaccinations

    RabiesDistemperLeptospirosisBordetellaK9 Influenza

    Pre-Screening Questions

    Is your dog more than eight weeks old? YesNo

    Do you have proof of your dogs current vaccinations? YesNo

    Does your dog have any health or physical limitations? YesNo

    Has your dog ever bitten another dog or human? YesNo

    Health Information

    Allergies

    Issues we need to be aware of?

    Physical Limitations

    Rate your dogs level of exercise/activity (playing, running) on a daily basis.

    OftenSometimesRarelyNever

    Pet Personality Profile




    If adopted, describe your knowledge of your dog’s past history.

    Number of People in Household






    Grooming History



    Dog's Reaction

    Flea/Tick Treatment

    Pet General Behavior

    Do visitors bring their dogs to your home?

    How does your dog react to strangers?

    How does your dog react to dogs of various sizes?

    Does your dog automatically fear or dislike particular types of dogs?

    How does your dog react to puppies?

    How does your dog react to another dog approaching him/her when you are out on a walk?

    Has your dog ever growled at someone?

    Has your dog ever bitten at someone?

    How does your dog handle being left alone?

    How do your dog act when you get home at the end of the day

    How does your dog show he/she is happy?

    Has your dog ever climbed or jumped over a fence?

    Does your dog have any challenges in the following areas? Mouthing, Housetraining, Barking, Digging, Ignoring commands.

    What kind of noises frighten your dog?

    What other things frighten or make your dog nervous?

    Does your dog growl or snap when food or toys are taken away?

    Has your dog ever shared food or toys with other animals?

    Does your dog play with toys?

    Does your dog play with other dogs?

    What kind of dogs does your dog like to play with?

    Pet Communication/Training

    Has your dog ever been trained?

    Has your dog ever had any canine education (obedience) training?

    If yes, when and where?

    What commands does your dog know?

    What hand signals do your dog know?

    Does your dog have a “release” word?

    Does your dog have a “quiet” command?

    Does your dog have potty “cue”?

    How often does your dog usually eliminate daily? At what times?

    Other

    Please add any other comments or information that you feel might be helpful to us in the evaluation process.


    By submitting this form, you agree to the terms and conditions


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