First Name *

Last Name *

Email *

Phone *

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City *

Zip code *

What are your travel dates? (please include estimated drop off and pick up times between 8am and 8pm) *

Dog's Name *

Dog's Breed *

Dog's Birthdate *

Spayed/Neutered? *

Last Rabies vaccination *

Last DHPP combo vaccination *

Last Bordetella vaccination *

Please upload your recent vaccination records. *

Who is your Veterinarian? *

Does your dog have any significant medical history? (bloat, previous seizures, urinary infections, etc) *

Is your dog on any medications? If so, please detail the name of the medication, how it is given (oral, injectable, and how often), and what it is for *

Tell us a bit about your dog's daily schedule *

What kind of food does your dog eat and what is their usual feeding schedule? *

How long is your dog left at home alone? *

Where does your dog stay when you aren't at home during the day or sleeping overnight? We do require dogs to be crate trained for overnights and times they aren't under direct supervision. Would this be an issue for your dog? *

When was the last time your dog stayed somewhere outside your home? Where was that and what was the outcome? *

Does your dog have any separation anxiety? Please be honest...it will help us greatly when considering placement. (pacing, whining, following you, chewing, not eating, barrier frustration) *

Is your dog 100% house trained? Does your dog mark in new environments? Please provide detail. *

Has your dog ever growled at, snapped at, or bitten a person? Provide detail *

Has your dog ever bitten, or attempted to bite, another dog? Provide detail *

What is your dog's previous experience with other dogs? Do they play regularly with other dogs? Are they comfortable with both smaller dogs and larger dogs? Please explain in detail * this is a home environment potentially with multiple dogs of variable sizes and personalities that must be friendly and tolerant* *

What is your dog's previous experience with cats. *

What is your dog's previous experience with children. *

What kind of Heartworm preventative is your dog on? *

Is your dog on Heartworm preventative year-round? *

Is your dog on Flea and Tick preventative year-round? *