Ithaca's Premier Dog Boarding Facility
Call today for reservations: 607-257-4338
Fill out the following questionnaire, print it out and bring it with you when you come to visit us. This will help us to know your dog better!
Or click here to download the forms in WORD format: Contract & Questionnaire
Address:_________________________________________________________
Street address City State Zip
Home Phone: ___________________ Work or Cell Phone:_______________
Emergency Contact Name and Number: ______________________________
Email Address:_______________________________________________
Please tell us about your dog so we can get to know them better.
Pet’s Name:_____________________________ Breed:_______________
DOB:____________ Weight:___________________ Color: ___________________
Sex: ____________ Neutered or Spayed?_________
Personality & Behavior: Yes/ No
Good with Children? __________
Good with other dogs? __________
Problem Chewer? __________
Basic Commands:
Sit __________
Lie down __________
Stay __________
Heal on Leash? __________
Is dog a runner? __________
Have they ever been boarded before? __________
Can you take toys or food away? __________
Has the dog ever bitten? __________
If yes, under what circumstances? _____________________________________________________
_________________________________________________________________________________
________________________________________________________________________________
__________________________________________________________________________________
Diet:
What brand of food do they usually get? _______________________________________________
When do they usually eat? __________________________________________________________
Can the dog have treats?___________________________________________________________
Any other special instructions?____________________________
Medical: Yes/No Date or include copy of Vet report
Known Allergies? ___________
Immunizations:
Rabies ___________ ___________________
Worm prevention ___________ ___________________
DHLLP ___________ ___________________
Bordetella
(Kennel Cough) ___________ _____________________
Flea Prevention? ___________ _____________________
Chronic Illnesses
(ear, eyes, etc)? ____________________________________________________________
Is the dog on any medication? ____________________
If yes, schedule of medication:__________________________________________________________
Other problems or restrictions? Explain:_________________________________________________
Name and Phone # of Veterinarian: _______________________________________________________
Anything else you can tell us about your dog that will make their stay with us more pleasurable and make them feel more at home?