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?
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?
How often does your dog exercise?
*
Rarely, 1 time per week or less.
Occasionally, 2 to 4 times per week.
Sometimes, 4 to 6 times per week.
Daily, runs for 15 minutes or more at least once a day.
Frequently, runs multiple times a day, and/or for longer than 15 minutes
Does not run, but goes for walks daily.
How would you describe your dog's overall temperament?
Does your dog have any fear or reactivity triggers? If yes, please list them.
Is your dog sensitive to being touched anywhere?
What are your goals for working with UpDog Gym?
*
Anything else we should know?
