Owners Name*

Dog's Name*

Dogs Age *

Dogs Breed*

How did you hear about us?*

What type of services are you looking for? *

What area are you located? (We have specific service areas we work within.)*

Ok with new people?*

Any history with bites or aggressive behavior? *

Please Explain if any history of bites or aggressive behavior*

Current routine? (Morning wake up to bedtime) *

Is your dog spayed or neutered?*

Does your dog have and wear a Collar, name tag and harness (Secure and non-damaged harnesses are required for any services with Roam Away From Home) *

Social Preference-do they walk well and socialize with others? *

How is your dog meeting new dogs?*

Is this your first dog? *

Does your dog have any separation anxiety, or ever exhibit any anxiety when not with owners or in their own home?*

If yes, please explain how your dog shows his/her separation anxiety*

How does your dog(s) react/respond to dogs larger or smaller than them? Please explain*

How does your dog(s) react/respond to dogs the same or opposite sex as them? Ex: Does your dog prefer males vs. females? Please explain*

Does your dog show any signs of reactivity or anxiety with their owners or alone with others? Yes or no, please explain.*

Have they ever escaped from current equipment?*

Has your pet slept in other places than their full time home?*

How does your dog or dogs do sleeping in a new place?*

Does your dog sleep in a crate?*

If no, please explain your dogs sleep routine and where /how they sleep at night *

Commands to practice while walking or during overnight stay

Does your dog(s) eat things off the street during walks?*

Post walk treats ok?*

Likes and dislikes*

Additional notes we should know?*

What dates are you looking for services? *