Jog-A-Dog Info Sheet

JOG-A-DOG INFORMATION SHEET

Today's Date: _____________

Client Name_________________ Dog's Name______________________

Address___________________________________ Age_____ Breed___________________

Phone (res)_________________ Sex: Male Female (circle one)

(bus)_________________ Neutered/Spayed

Cell phone/pager_______________________________________________

E Mail________________________________________________________

Colour & Markings of Dog:________________________________________________________

Days and times walks are required:_____________________________________________________

Dog's Characteristics: Please state yes or no beside each statement:

Comes when called ______ Good with other dogs _______

Plays with ball _____ Will go in water _______

Likes children ______ May be given treats _______

Must be kept on leash ______ Scared in thunderstorms ______
Chases joggers/squirrels/cats ______ Barks at strangers______

Dog's background (ie. Acquired as puppy/from Humane Society, etc.):__________________ ______________________________________________________________________________

Veterinarian: Name of Clinic:_____________________________________________________

Phone:_______________________

Number where you may be reached:_____________________________________________________

Friend or neighbour that may be contacted in client's absence or emergency:

Name:___________________________________________________________

Address:_________________________________________________________

Phone:___________________________________________________________

Any additional comments or special requirements: ______________________________________________________________________________

Signing below acknowledges that Jog-A-Dog personnel may enter your home for the purpose of picking up/returning your pet and to transport your pet by car. Jog-A-Dog and its personnel shall assume no liability for any illness or injury caused to your pet or to other persons, pets or property. If your pet becomes injured or ill, Jog-A-Dog is hereby authorized to take your pet to the nearest animal care facility and such expense shall be paid by the owner of the pet.

Signature___________________________________________________

Client Name_________________	Dog's Name______________________
Address___________________________________	Age_____ Breed___________________
Phone (res)_________________	Sex: Male Female (circle one)
(bus)_________________	Neutered/Spayed
Cell phone/pager_______________________________________________
E Mail________________________________________________________
Colour & Markings of Dog:________________________________________________________
Days and times walks are required:_____________________________________________________
Dog's Characteristics: Please state yes or no beside each statement:
Comes when called ______	Good with other dogs _______
Plays with ball _____	Will go in water _______
Likes children ______	May be given treats _______
Must be kept on leash ______	Scared in thunderstorms ______
Chases joggers/squirrels/cats ______	Barks at strangers______
Dog's background (ie. Acquired as puppy/from Humane Society, etc.):__________________ ______________________________________________________________________________
Veterinarian: Name of Clinic:_____________________________________________________
Phone:_______________________
Number where you may be reached:_____________________________________________________
Friend or neighbour that may be contacted in client's absence or emergency:
Name:___________________________________________________________
Address:_________________________________________________________
Phone:___________________________________________________________
Any additional comments or special requirements: ______________________________________________________________________________
Signing below acknowledges that Jog-A-Dog personnel may enter your home for the purpose of picking up/returning your pet and to transport your pet by car. Jog-A-Dog and its personnel shall assume no liability for any illness or injury caused to your pet or to other persons, pets or property. If your pet becomes injured or ill, Jog-A-Dog is hereby authorized to take your pet to the nearest animal care facility and such expense shall be paid by the owner of the pet.
Signature___________________________________________________