Registration Form | Doggieland

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Fill in the registration form once, and we will get in touch with you. We really look forward to meeting you and your dog!

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Personal Information
Owner's Name*
First Last
Address*
Street Address City Province Postal Code
Mobile #*
Home #
Work #
Email*
From time to time we would like to send you information about news and services relating to your dog at Doggieland. Please provide your consent if you wish to receive this information.
- I consent.
We regularly post pictures on Doggieland's social media platforms (Facebook. Instagram, Twitter, etc.) of dogs enjoying our services. Please provide your consent that Doggieland is authorized to post pictures of your dog on our social media sites. Only the dog's first name and breed will be identified.
- I consent.
How did you hear about us?*
- Referral
- Social Media
- Vet
- Google
- Other
Were you referred by someone? If so, by whom?
Please indicate at which location you would like to have your Consultation conducted*
- North Toronto
- Vaughan
- Bloor West
What services are you interested in?*
- Boarding
- Daycare
- Grooming
- Training
- Personal Walks/Home Visits
- Pick-up/Drop-off
Select all that apply.

Emergency Contact
In the event of an emergency, if we were unable to get in touch with you, please provide contact information for someone who is able to make decisions for your dog on your behalf.
Name*
First Last
Contact #*
Other #
Relationship*

Dog Information
Pet Name*
Breed or Mix*
Weight*
Date of Birth*
Date Format: MM slash DD slash YYYY
Sex*
- Male
- Female
Spayed/Neutered*
- Yes
- No
Where did you get your dog?
When did you get your dog?
Has your dog ever attended daycare or boarding?*
- Yes
- No
If so, where?
Name of Facility
Location of Facility
What brand of food do you feed your dog?
Amount per feeding?
How many times a day?
How is your food served?
- Wet
- Dry
- Warm
- Cold
- Room Temperature
- Other
What treats do you feed your dog?
Does your dog have any allergies?*
- Yes
- No
If yes, please describe
Please describe anything else you feed/give your dog that we need to be aware of (vitamins, supplements, antibiotics, etc.)
Veterinarian Information
Vet Clinic Name*
Dr. Name
Address
Street Address City Province Postal Code
Phone*
Email
Do you have pet insurance?
- Yes
- No
If yes, which insurance provider are you using?

Dog's Health
Please describe your dog’s current health condition*
Is your dog's Rabies shot up to date?*
- Yes
- No
If not, why?*
Last Rabies vaccination date*
Is your dog's DHPP shot up to date?*
- Yes
- No
If not, why?*
Last DHPP vaccination date*
Is your dog up to date on their Bordetella vaccine?*
- Yes
- No
If not, why?*
Last Bordetella vaccination date*
Has your dog ever had fleas?
- Yes
- No
If yes, when?
What flea/parasite control do you use?*
Has your dog been diagnosed with any communicable disease, bacteria or parasite in the last 30 days?*
- Yes
- No
If yes, please describe
Has your dog had any surgeries (other than spay/neuter)?*
- Yes
- No
If yes, please describe
Please list any other conditions your dog may be suffering from (i.e. hip dysplasia, hot spots, etc.)

Temperament
Please describe your dog’s temperament*
How does your dog react when meeting new dogs?*
Does your dog play well with other dogs?*
- Yes
- No
Is there a specific breed or type of dog that your dog is either intimidated by or agitated by?*
How does your dog react when s/he is approached by strangers?*
Does your dog have any phobias or fears?
Has your dog ever bitten another dog or a human?*
- Yes
- No
If yes, what happened?
Has your dog ever been bitten by another dog?
- Yes
- No
If yes, what happened? (Please also describe the dog)
Has your dog ever growled or snapped at a human/dog when food or toys were taken away?*
- Yes
- No
If yes, what happened?
Does your dog listen to other humans, besides his/her owners?:
- Yes
- No
- Unsure
Is your dog crate trained?*
- Yes
- No