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Lucky Paws Dog Enrollment Form


Dog Information:

Pet Name: DOB: / Male Female Size:
Breed: Color: Spayed/Neutered?

Vaccinations:
Food:

Is this dog current on the following vaccinations?
•Distemper •Bordatella •Rabies
Please provide documentation on all of these vaccinations.
Amount: AM PM
Food Notes:
Has this dog ever shown signs of food aggression?

Evaluation Questionnaire:

1. Has this dog socialized with dogs outside of your household?
2. How does this dog socialize with other dogs?
3. How does this dog socialize with new people?
4. Do you expect this dog to do well in the Lucky Paws daycare enviornment?
5. Does this dog have any injuries or health issues we should know about? (explain below)
Additional Comments:

Terms & Conditions:

I agree to allow this dog to co-mingle, to the terms and conditions above, and certify that all information provided is accurate to the best of my knowledge. Date:
Full Name: (acts as signature) Phone: --

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