Planet Pooch

About You
  Primary Owner Other Owner
First Name(s):
Last Name(s):

 

 Please enter full phone numbers below, area code first, digits only.
Home Phone: 
Work Phone:
Cell Phone:
E-mail:
     
Address:  
City:  
State:  
Zip:  
Preferred Location:   

Upon enrollment, Planet Pooch offers your dog a personalized Planet Pooch nametag. This nametag is included in the price of your dog’s temperament evaluation.

What phone number would you like us to put on your dog’s Planet Pooch nametag?
About Your Pooch
Name:
Sex: Male   Female
Age:
Birthday:
Breed(s): (if your dog is a mix, please try your best to guess the breeds)
Color(s):
Weight: Approximately pounds.
Veterinary Clinic:
Clinic's Address:
Clinic's Phone:
   
Vaccinations
Is your dog current on his/her Rabies vaccination?
Is your dog current on his/her DHLPP (or similar) vaccination?
Is your dog current on his/her Bordetella (kennel cough) vaccination?
Is your dog current on his/her Canine Influenza vaccination?
Questions

Below are some questions we'd like you to answer so we can learn more about your dog.

What form of flea control do you use?

Is your dog spayed or neutered? (Male dogs older than one year of age must be neutered and all female dogs must be spayed regardless of age.)

At what age was your dog spayed or neutered?

How long have you owned your dog?

How does your dog react to puppies?

How does your dog react to dogs a great deal smaller than him/her?

How does your dog react to dogs a great deal larger than him/her?

Has your dog ever bitten a person? If yes, please explain.

Has your dog ever bitten another dog? If yes, please explain.

Does your dog have experience in playgroups, doggie daycare, and/or dog parks? If so, please explain your experience.

Is there anything else we should know about your dog?

What services do you seek from Planet Pooch? (select all that apply)
     Daycare
    Boarding
    Grooming
    Behavior consultation

How did you hear about Planet Pooch? (Please be as specific as possible -- if from a friend, tell us your friend’s name; if through an internet search engine, please tell us which one; etc.)

Corporate Discount Eligibility
Public Service Discount Eligibility
Policies