Puppy Love
475 Salem Woods Drive
Marietta, GA 30067
404-806-7065

Cell ________________________Home Phone _____________________Work_______________________
Contact Person other than Yourself ______________Relationship ___________Phone ________________

Pet (s) Information
Pet Name(1): __________________  Breed: ____________________  Color: ________________________
Pet Name(2): __________________  Breed: ____________________  Color: ________________________
Pet Name(3): __________________  Breed: ____________________  Color: ________________________
Weight: ____________Age: _____________Sex:_____________ Spayed/Neutered? __________________

Does your pet have any :
Health Problems? (Explain) __________________________________________________________________
Behavior Issues (i.e. thunderstorms)? (Explain) ___________________________________________________
Ever bitten another dog or human? _____________________________________________________________
Please describe your dog's personality/behavior with other dogs and people (friendly, shy, playful, aggressive, fearful): _______________________________________________________________________________  
Favorite Games: ______________________Favorite Scratch Place (circle):   Head  -  Back  -  Belly  -  Ears
Dislikes:  ____________________________Does your dog live indoors or outdoors? In________ Out______
Is your dog potty trained? Yes___ No___   May we give treats to your dog? Yes_________ No___________

Veterinarian information
Veterinarian Name: _______________________________________  Phone:___________________________
Address: __________________________________________________________________________________
May we contact? Yes___ No___
Dates of Last Vaccinations
Rabies_________Bordatella__________Distemper Combo Vaccination (DHLPP/DHLP)_________________
Must be on flea control to stay at Puppy Love: Method/Brand :______________________________________