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Utopia for your pet…
Peace of mind for you!
416.456.6131
info@shangri-paw.ca
www.shangri-paw.ca
Today’s Date
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Owner’s Name
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Address
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Email Address
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Phone Numbers (Home, Work, Cell, etc.)
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Alternate Contacts While You’re Away (Names & Numbers)
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Name of Veterinarian
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Clinic Phone Number
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Dog’s Name
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Breed
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How does your dog socialize with other dogs?
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Dog’s Date Of Birth
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Has your dog ever been separated from you before?
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Please Choose
Yes
No
How does your dog handle being separated from you?
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Is your dog spayed / neutered?:
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Please Choose
Yes
No
Does your dog have any chronic illnesses? (Please list)
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Does your dog have any allergies? (If so, please list)
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Is your dog microchipped?
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Please Choose
Yes
No
Medication for illness (Please list, with any instructions)
Are all shots are up to date?
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Please Choose
Yes
No
Does your dog have flea protection?:
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Please Choose
Yes
No
Is your dog protected from heart worm disease?
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Please Choose
Yes
No
What brand food does your dog eat?
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Feeding Schedule (Quantity & Frequency)
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What is your dog’s daily schedule like? (Walks, bathroom breaks, etc.)
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Does your dog have any anxieties? e.g. thunder, fireworks, rain
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If your dog suffers from anxieties, how do you comfort him/her?
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Where does your dog usually sleep?
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Do you use a crate?
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Please Choose
Always
Sometimes
Never
Is your dog house trained?
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Please Choose
Yes
No
How Did You Hear About Our Services?
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Anything else you feel is important for us to know about your dog?
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