K9 Konnect Club Intake Form

REQUIRED FOR EACH DOG

First name*

Last name*

Email*

Phone*

Address*

Emergency Contact Number*

Preferred Veterinarian

Vet Phone Number

Arrival Date*

Pickup Date*

Canine Name*

Breed*

Dog Food Type (must be provided)*

Normal Feeding Time*

Amount*

Medications List and Dosage information*

Sprayed/Neutered*

Yes

No

Bite History*

Yes

No

Fence Jumper*

Yes

No

Plays well with others*

Yes

No

Separation Anxiety*

Yes

No

Leash Trained*

Yes

No

Scared of storms*

Yes

No

Sleeping Preference*

Crate

Kennel

Shot Record (or bring with you to the drop off)

Any additional information?

Please note: We have leashes, toys, balls, and feeding bowls. If you bring any items be aware that other dogs may claim ownership. We will do our best to return. Thanks

How did you hear about us?*

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