JOG-A-DOG INFORMATION SHEET FOR DOG WALKING
Today’s Date: _____________
| Client Name_________________ | Dog’s Name______________________ | ||
| Address___________________________________ | Age_____ Breed___________________ | ||
| Phone (res)_________________ | Sex: Male Female (circle one) | ||
| (bus)_________________ | Neutered/Spayed | ||
| Cell phone/pager_______________________________________________ | |||
| E Mail________________________________________________________ | |||
| Colour & Markings of Dog:________________________________________________________ | |||
| Days and times for walks:_____________________________________________________ | |||
| Dog’s Characteristics: Please state yes or no beside each statement: | |||
| Comes when called ______ | Good with other dogs _______ | ||
| Plays with ball _____ | Will go in water _______ | ||
| Likes children ______ | May be given treats _______ | ||
| Must be kept on leash ______ | Scared in thunderstorms ______ | ||
| Chases joggers/squirrels/cats ______ | Barks at strangers ______ | ||
| Loves garbage/people food ______ | May be allowed on furniture ______ | ||
| Jumps/climbs/digs ______ | Likes to chew ______ | ||
| Dog’s background (ie. Acquired as puppy/from Humane Society, etc.):__________________ ______________________________________________________________________________ | |||
| Veterinarian: Name of Clinic:_____________________________________________________ | |||
| Phone:_______________________ | |||
| Number where you may be reached:_____________________________________________________ | |||
| Friend or neighbour that may be contacted in client’s absence or emergency: | |||
| Name:___________________________________________________________ | |||
| Address:_________________________________________________________ | |||
| Phone:___________________________________________________________ | |||
| Any additional comments or special requirements (ie. feeding schedule/medications/allergies: ______________________________________________________________________________ |
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| Signing below acknowledges that Jog-A-Dog personnel may enter your home for the purpose of picking up/returning your pet and to transport your pet by car. Jog-A-Dog and its personnel shall assume no liability for any illness or injury caused to your pet or to other persons, pets or property. If your pet becomes injured or ill, Jog-A-Dog is hereby authorized to take your pet to the nearest animal care facility and such expense shall be paid by the owner of the pet. | |||
| Signature___________________________________________________
If you’re unable to print out this page or would like to be emailed the form please email me at: jogadog.ca@gmail.com |
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