New Customer Registration

Please note: You will only need to fill out this form when you have an APPROVED RESERVATION for your pet and this is their first time coming to Canine Cabana.

Each dog must have a separate enrollment form. Please write neatly and be as thorough as possible. This form is a very important part of our evaluation. Each dog is unique and there is no right or wrong answers.

Contact Info

Your Name
Email
Home Phone Number
Cell Phone Number
Work Phone Number
Address
City
State
Zip
Employer
Employer Address
How'd you hear about us?

Any person other than yourself that is authorized to pick up your dog?

Name
Phone


Emergency Contact

Someone that resides outside of your household and will not be travelling with you while your dog visits our facility.

Name
Email
Home Phone Number
Cell Phone Number
Work Phone Number
 

Pet Information

Dog's Name
Dog's Breed
NeuteredSpayedInTact
If applicable, when was the spay/neuter surgery OR expected age to be done?
Colors / Markings
Birthday or Age
 

Pet Medical Information

Veterinarian
City & Phone
Does your dog take any medication, vitamins, or other supplements?
YesNo
If Yes, please list below, giving name of medication, directions for use, and reason for medication.
What type of flea and/or tick control medicine is your dog currently taking?
What type of heart worm preventative is your dog currently taking?
Does your dog have any preexisting medical conditions or has he/she had any surgeries other than spay/neuter surgery?
YesNo
If Yes, please explain:
What brand/type of food do you feed your dog?
How much do you feed and how frequently (eg. 2cups/2x/day)?
Does your dog have any allergies?
YesNo
If food allergies, please list here or mark as unknown.
If environmental allergies, please list here or mark as unknown.
 

Additional Information

Where did you get your dog?
When did you get your dog? How old was he when you first brought him home?

How many people are in your household?

Adults
Male
Female
Children
Boys
Girls
Please explain how your dog behaves around children:
How do you exercise your dog? Walking, running, playing ball, etc. How frequently and how long?
How does your dog react when strangers approach the home or yard?
While on a leash?
Has your dog ever growled at any person?
YesNo
If Yes, please explain:
Has your dog ever bitten a person or other animal?
YesNo
If Yes, please explain:
Are there any other animals in your household?
YesNo
If Yes, please list species/breed, name, age and whether they are spayed/neutered:
Does your dog get along with the other animals in the household?
YesNo
If No, please explain:
Is your dog crate trained?
YesNo
How long does your dog spend at home alone? Is he/she in a crate when you are gone?
Is your dog house trained?
YesNo
Does your dog bark a lot?
YesNo
Please explain:
Does your dog play off leash with other dogs?
YesNo
If Yes, how frequently, where, and how many dogs at a time?
If no, please explain:
Do you take your dog to a dog park?
YesNo
How often and when was the last trip?
How does your dog react when another dog approaches the following?
Your home

On a leash

At a fence
If your dog has something in his mouth you do not want him to have, will he drop it if asked or allow you to remove it from his mouth?
YesNo
Where does your dog like to be petted?
Does your dog have any sensitive areas or places that he does not like to be touched?
YesNo
If Yes, please explain:
Has your dog ever escaped?
YesNo
Dug under anything?
YesNo
Climbed or jumped a fence?
YesNo
If Yes to any of the above, please explain:
If you are completing this form for daycare, what is the main reason that you have chosen daycare
for your dog?
Has your dog ever visited another daycare/lodging facility?
YesNo
If Yes, what facility and how long ago? What made you decide to look for a new facility?
 

Training History

Are you interested in our training programs?
YesNo
Has your dog been to a training class previously?
YesNo
If Yes, how long ago? What facility did you use?
Previous training type?
Group LessonsPrivate LessonsIn Home

What behaviors does your dog know and how well?

Name
Always PerformsUsually PerformsNeeds Work
Sit
Always PerformsUsually PerformsNeeds Work
Stay
Always PerformsUsually PerformsNeeds Work
Down (lay down)
Always PerformsUsually PerformsNeeds Work
Come
Always PerformsUsually PerformsNeeds Work
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