Your Name
*
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Cell Phone or Primary Number
*
(###)
###
####
Home Phone
(###)
###
####
Preferred Contact Method
How did you hear about us?
Internet search (google, bing, etc.)
Facebook
Instagram
A pet professional (vet, trainer, groomer)
Word of mouth (friend, family, neighbor)
Mail or flyer (postcard mailed to me)
Other
If you were referred by someone, please list the person's name or business name below.
Vet's Name
*
Vet's Phone Number
*
(###)
###
####
Breed
Dog's Age
*
Dog's birthday or "Gotcha" day
MM
DD
YYYY
Dog's Weight in Lbs
*
Dog's Sex
*
Female
Male
Is your dog spayed/neutered?
*
Yes, dog is spayed neutered
No, dog is intact
Rabies Expiration Date
*
Please have proof of rabies vaccine available during your first visit, or forward a copy in advance to info@updoggym.com (preferred).
MM
DD
YYYY
Does your dog have any known allergies?
*
Yes, listed below
No known allergies
Dog's Allergies:
Is your dog taking any medications or supplements?
Does your dog have any illnesses, injuries, or have they had any surgeries we need to be aware of?
*
Yes, listed below
No, no illnesses, injuries, or recent surgeries.
If yes to the above, please describe your dog's illnesses, injuries, or surgeries.
How would you describe your dog's overall temperament?
If you answered yes above, describe any times your dog has bitten or become aggressive with people or animals.
Does your dog have any fear or reactivity triggers? If yes, what does your dog react to?
What are your dog's favorite treats or toys?
What are your goals for working with UpDog Gym?
*
Anything else we should know?
