New Client Registration

If your dog has yet to experience the wonder of A Dog Gone Good Place in person, please
fill out our Client Registration Form. If their is more than one dog in the family we
will need a registration for EACH.

All fields MUST be filled in or your form will not submit.  If your dog does not exhibit the behavior please put N/A

Last Name:
First Name:
Full Address: (street,city,state,zip)
Email Address:
Phone Numbers: Cell Business
Home
Emergency Contact:
Vet.Name/Address/Phone/Clinic Name
How did you hear about us?:
  Dog Information

Dog's Name/Birth Date

Breed

Gender/Altered
Vaccination Dates

Bordetella

Rabies

DHLPPC

Flea Treatment
  Personality Assessment
How Long have you owned your dog?
Where did you get your dog?
If adopted do you have information on prior history
Household members

Number of adults:
Number of children:

Any other animals in household?

YES NO

How do they get along?
List activities shared with your dog


Is your dog aggressive towards any of the following:

Food----> YES NO

Toys----> YES NO

Treats--> YES NO
Has your dog attended any formal obedience classes?
Is your dog crate trained? YES NO
What is your dog's reaction to the following:

Puppies-

When another dog approaches-

Off leash at dog park-

Out on leash-

When you leave home-

Under what circumstances does your dog exhibit the following behavior?

Barking/Growling

Jumping

Digging

Biting/Mouthing

Destructive Chewing

Mounting

Separation Anxiety

Running Away

Has your dog ever biten?
Does your dog have any physical elements that will limit it's play?
Has your dog attended play care before? if so where?
Is there anything you would like us to know about your dog?

Clicking this submit button will send your dog's registration to us via email.  Once recieved we will contact your vet for your dog's vaccination records. NOTE: some vets do not allow us to obtain these records, if this is the case we will call and let you know.  Once all vaccinations are verified and up to date we will contact you to set up your dog's 1/2 day evaluation.

Thank You for Choosing Us!