CURRENT NAME:____________________________________________________

AGE:__________ COLOR:__________________________ SEX:________

MEDICAL: SPAYED OR NEUTERED:________________ DATE:________________

RABIES VACCINATION:________DATE:_____________EXPIRES:_______________

OTHER SHOTS AND DATES:_________________________________________

ALLERGIES:______________________________________

MEDICINE______________________________

DEWORMING:_________________________________DATE________________

DOG’S LIKES: WATER:____ CHILDREN:______ CATS:______ OTHER DOGS:______

STRANGERS:______ PLAY:____ RIDES IN A CAR:______

SPECIAL TOYS:________________________BLANKET:______

OTHER:____________________________________________________________

HABITS: HOUSEBROKEN:___________ SIGNAL TO GO OUT:________________________

JUMPS FENCES:____ DIGGING:______CHEWS FURNITURE OR OTHER ITEMS:__________

LEASH TRAINED:______COLLAR:____HALTER:______

TRAINING RECEIVED_______________________________________________________

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FEEDING INSTRUCTIONS:___________________________________________________

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