Application Form

Dog Information

Dog's Name:
Gender: Male Female
Age:
Color:
Breed:
Weight: lbs.
Birthdate:
Spay/Neutered:
Tattoo/Microchip#

 

Mom & Dad Information

Name:
Email Address:
Address:
City/State/Zip:
Cell#
Home#
Work#
How did you first hear about us? (We want to reward our referrals!)
If you found us on the Internet, please tell from where (i.e. Yellow Pages/Sun Sentinel/Google/Yahoo/MSN Search)?
if Other...
What are your primary reasons for bringing your dog to Family Dog Central?
List anyone who has permission to pick up your dog?

 

Emergency Contact Information

Name:
Relationship:
Contact #

 

Dog Medical/Food Information

Veterinarian Name:
Hospital:
Phone:
Address:
City/State:
 
Yes
No

Does your dog have any medical conditions or allergies?
If yes, describe:

 

Is your dog currently taking any medications?
If yes, what are they?

 

Does your dog have a physical/health condition that would merit restrictions on his activities?
If yes, describe:

 
What brand of heartworm preventative do you give your dog?
Date Last Given:
What brand of flea/tick preventative does your dog take?
Date Last Given:
What brand of food do you give your dog? Dry or Wet
Morning Quantity:
Noon Quantity:
Evening Quantity:

Any special feeding instructions?

 

Dog History/Behavior/Personality

Where did you get your dog?
How long has your dog been in your family?
 
Yes
No
Has your dog ever stayed overnight outside?
If yes, where?

Has our dog every socialized with a large group of dogs?
If yes, describe:

Any PERSON, type of DOG, or SITUATION your dog seems to have problems with?
If yes, please describe:

Has your dog every growled at or bit another PERSON or DOG?
If yes, what were the circumstances?

Does your dog growl/bite when you take food/toys away from him?
Has your dog ever jumped a fence?

Any areas on your dog’s body where he DOES NOT like to be touched?
If yes, which areas:

Overall, how would you describe your dog’s temperament and personality?

Rate your dog’s energy level, “1” being MELLOW/CALM and “10” being
a 24/7 BALL CHASER/JUMPER/SWIMMER
What commands does your dog know?

What else should we know about our future dog client?

What services do you seek from Family Dog Central?
Daycare Overnight Stays Grooming Training Seminars
 Other:

HOME | SERVICES | FACILITY | RATES | FAQS | PHOTOS | NEWS | EVENTS
RESOURCES | CONTACT US | SITE MAP
©2007-2008 Family Dog Central - 1807 S. Powerline Rd, Ste 101, Deerfield Beach FL 33442. All Rights Reserved

 

Family Dog Central provides dog daycare and overnight dog stays in a unique environment, different than just a dog boarding kennel.
We serve all South Florida dogs from Deerfield Beach, Coral Springs, Coconut Creek, Parkland, Pompano Beach, Margate, Fort Lauderdale,
West Palm Beach, Boca Raton and across Broward and Palm Beach counties.

Designed & Hosted by Inspired 2 Design, LLC