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First Name:
Last Name:
Street Address:
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Major Cross-Streets:
Day Phone:
Evening Phone:
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Date and time you will be leaving:
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Dog Profile
Is your dog spayed or neutered?
Yes
No
Is your dog house-trained?
Yes
No
Is your dog aggressive toward adults?
Yes
No
Is your dog aggressive toward children?
Yes
No
Is your dog aggressive toward dogs? Please explain
Yes
No
Has your dog ever bitten anyone?
Yes
No
Does your dog have any health issues? Please explain:
Yes
No
Does your dog have any behavioural problems? Please explain:
Yes
No
Does your dog use any medication? Please explain:
Yes
No
Is there anything else about your pet we might need to know?
Do you have any special instructions for your host family?
Does your dog live with children? Min age and max age:
Is your dog aggressive toward cats? Please explain:
Yes
No
Where does your pet sleep?
Emergency Contacts
Emergency Contact One:
Name:
Phone Number
Emergency Contact Two:
Name:
Phone Number:
Veterinary Information
Veterinary Name:
Veterinary Number:
Veterinary Street Address:
Province:
Postal Code:
Major Cross-Streets:
Hounds On Holiday... The Unique Alternative To Kennels
77 Creighton Avenue, Guelph, Ontario N1E 0H6 - Tel: 519-835-5588 - Cell: 519-835-0264
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