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

 Male Female

Spayed/Neutered

 Yes No

Pet Parent Information











Veterinarian Information





Proof of Required Vaccinations

 Rabies Distemper Parvo Bordetella K9 Influenza

Pre-Screening Questions

Is your dog more than four months old?  Yes No

Do you have proof of your dogs current vaccinations?  Yes No

Does your dog have any health or physical limitations?  Yes No

Has your dog ever bitten another dog or human?  Yes No

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.

 Often Sometimes Rarely Never

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.


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