* Required
 
  

   Welcome to ........
   Buddy's Barking Lot

   An Exceptional Doggie Day Care Facility
  
  
   
 
Online Registration Form
   

Owner Information

* Name
* Address
* City
* State
* Zip-Postal Code
* Home Phone
Work Phone
Cell Phone
*E-mail

                   

                Emergency Contact
  
Name
Relationship
Phone

               

                Dog Information

  
Name
Breed 
Color(s)
Date of Birth
Weight
Sex: Male Female

               

                Veterinarian
 
Name
Animal Hospital
City
State
Zip-Postal Code
      
                  
 
     How many people live in your home?   
     Total Adult Males 
     Total Adult Females 
     Total Male Children    Ages  
     Total Female Children   Ages
     List other animals living in your house  
     How long have you had your dog? 
     Where did you get him/her? 
     Are there any restrictions you would like be placed on your dogs’ time with us?, and if so what? 
   
     Does your dog have any special needs?  Yes ,  No    If Yes what are they?  
     List three words that describe your dog 
     How long are you away from your dog during the day on week days? 
     How long are you away from your dog during the day on weekends? 
     Where does he/she stay during that time? (crate, kitchen, back yard, etc.) 
     Where does your dog sleep when he/she is home with you?  
     Is your dog housebroken?  Yes   No 
     What commands does your dog know?  
     Is there any type of person your dog is uncomfortable with? (kids, the mail man, etc.) 
     Is there any type of dog your dog seems to have a problem with? 
     Do visitors bring dogs to your home ?   Yes   No    If Yes how does your dog react? 
     How does your dog react to strangers coming into or near your home? 
     Is it common for your dog to jump on you or other people?   Yes    No 
     Has your dog ever growled at another person or dog?  Yes    No 
     If yes, please describe the circumstances 
     Can you take a food based item away from your dog without him/her growling at you?   Yes    No 
     Will your dog readily share toys with other dogs?  Yes    No 
     Has your dog ever jumped a 6 foot fence?  Yes    No 
     Are there any areas on your dog’s body that he/she doesn’t like to be touched?, if so which ones? 
   
     Has your dog ever socialized with a large group of other dogs?  Yes    No 
     Does your dog like to wrestle with other dogs?  Yes    No 
     If yes, does he/she usually take the top (dominant) or bottom (submissive) position during wrestling? 
     When your dog meets another dog off-leash, describe how he/she reacts: 
     Has your dog played with other dogs under 15 lbs?  Yes    No 

                  

                Vaccination Checklist

     DHHLP
     Bordatella
     Rabies
     Does your dog have any allergies? Yes No
     If yes, please explain
    
     Please share any other information that you think would assist us in providing the
     best possible care and most fun for your dog while he/she is visiting us:
    
      

                                                                 
Buddy's Barking Lot, Inc.
3 American Legion Drive
Ardsley, NY 10502-1803
914.591.7645 (Ofc.)   914.591.7235 (Fax)
E-mail: info@buddysbarkinglot.com 
     
                                                                        
                                                                       
         
                                                                		 
                                                   
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