E-Mail Address (required) : Name of Dog: (required) Gender: (required) Age of Dog: (required) Breed: (required) How long have you owned your dog? (required) Altered? (required) (* All pets over 6 months of age are required to be spayed or neutered in order to participate in daycare.) Medical History
Does your dog have any past or current medical issues or injuries we need to be aware of? (required) If yes, please explain. Is your dog current on age appropriate vaccinations? (required) (* To attend daycare your dog must be current on Rabies, DAPP, and Bordetella vaccines.) If you are not a veterinary patient of Heart of Ankeny please list your veterinarian. (required) Is your dog current on flea/tick and heartworm prevention? (required) (*to attend daycare it is required that your dog is current on flea/tick prevention.) If yes, please list what products you are currently using. Does your dog have any allergies or dietary restrictions? (required) If yes, please explain. Training History
Has your dog attended any training or obedience classes? (required) If yes, please list classes/training attended below. What commands does your dog know and respond to? (required) Do you use and electronic fence or bark collar for your dog? (required) If yes, please explain. Social History
Describe your dog's energy level. (required) Has your dog ever bitten or been aggressive with a person? (i.e. groomer, vet, strangers) (required) If yes, please explain. Has your dog ever shown aggressive behavior towards another dog? (required) If yes, please explain. Has your dog ever been in a situation with another dog that resulted in a bite wound to either dog? (required) If yes, please explain. Does your dog have issues with loud noises or thunderstorms? (required) Does your dog exhibit destructive behavior when left alone? (required) Does your dog willingly accept handling by others? (i.e. grooming, nail trims, etc.) (required) Is there anything your dog is scared of? Please list below and explain how you handle it (required) Please list some of your dog's favorite activities. (required) Has your dog ever jumped a fence or gate higher than 4 feet? (required) (If yes, please list training completed.) Does (or has) your dog shown signs of resource guarding? (toys, objects, people, etc.) (required) If yes, please explain. Has your dog been to an off leash park? (required) Does your dog get along with other dogs or ever play in a group setting? (required) Does your dog recall well? (required) Does your dog ever bark excessively? (required) Why do you want to bring your dog to play time? (required)
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