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NEW CLIENT FORM
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This field is for validation purposes and should be left unchanged.
Pet Information
Name
(Required)
Birthday
MM slash DD slash YYYY
Breed
(Required)
Gender
Male
Female
Neutered
Spayed
Special needs / Important information:
Owner Information
Name
(Required)
Address
(Required)
Home Number
Work Number
Cell/Pager Number
(Required)
Email
(Required)
How did you hear about us?
(Required)
Jeff Murphrey
Adrienne Murphrey
Wade Whilden
HDR Employee "Please fill out other"
Current Client "Please fill out other"
Memorial Buzz
Pet Talk Magazine
Internet
Grooming Van
Bunker Hill Village
Living Magazine
Memorial Villages Magazine
Instagram
Facebook
Memorial Information Trading
School "Please fill out other"
Gala "Please fill out other"
Internet Search
Houston Dog Ranch Newsletter
Other
Vet Information
Clinic
Veterinarian
Phone Number
New Client Application
Has your dog ever boarded at a kennel or veterinarian clinic?
Yes
No
Does your dog enjoy boarding?
Yes
No
Describe the overall experience
Is your dog housetrained?
Yes
No
Does your dog have sensitivity to thunder or noise?
Yes
No
Describe his/her typical reaction:
Does your dog know how to use a dog door?
Yes
No
Does your dog have issues with men?
Yes
No
Describe his/her typical reaction:
How does your dog react to strangers, in your home
In public
Does your dog have food allergies?
Yes
No
What is he/she allergic to?
Does your dog have any other allergies?
Yes
No
What is he/she allergic to and what is the current treatment?
Is your dog prone to hotspots?
Yes
No
How do you treat hotspots?
Does your dog have any health issues/concerns or physical limitations (ie. Ear infections, hot spots)?
Yes
No
Please describe in detail
Does your dog have frequent diarrhea?
Yes
No
Sensitive stomach?
Yes
No
What do you do when these issues arise?
Does your dog climb/jump fences?
Yes
No
How high?
Has your dog ever shown aggression toward a human?
Yes
No
Has your dog ever bitten a person?
Yes
No
Has your dog ever shown aggression toward a dog?
Yes
No
Has your dog ever bitten a dog?
Yes
No
Please describe the incident
Is your dog leash reactive or a fence fighter?
Yes
No
Does your dog have issues being handled?
Yes
No
Describe in detail the parts of the body and reaction
What brand of food does your dog eat?
Is your dog on monthly flea/tick preventative?
Yes
No
Brand
Is your dog comfortable being groomed?
Yes
No
Please describe
Do you have a reservation request in mind?
Please enter the dates below and the accommodation you are requesting and we will reach out to you once we have your information entered to see if we can accommodate.
Arrival Date
MM slash DD slash YYYY
Departure Date
MM slash DD slash YYYY
Accomodation
Bunkhouse
Deluxe Bunkhouse
Private Cabin
VIP Cabin
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