top of page

Home
About Us
The Space
Contact
Book Now

New Client Intake Form

Client Information

First Name*

Last Name*

Email Address*

Phone Number*

Address*

Emergency Contact

Emergency Contact Name*

Emergency Contact Phone Number*

Pet Information

Pet Name*

Breed / Mix*

Spayed / Neutered*

Yes

No

Sex*

Male

Female

Age*

Weight / Size*

Pet Photo*

Health & Veterinary Information

Primary veterinarian name, clinic, phone, and address.*

Current Vaccinations / Veterinary Records*

Known medical conditions, injuries, surgeries, or chronic issues.*

Current medications or supplements (name, dose, frequency,reason)*

Allergies (food, environmental, medication)*

Dietary information: brand of food, feeding schedule, treats allowed/forbidden. *

Any special medical handling notes.*

Temperament & Behavior Assessment

General Demeanor

Overall Energy Level*

Low

Moderate

High

Variable

Typical Response to Strangers*

Friendly

Cautious

Fearful

Reactive

Aggressive

Response to Other Dogs*

Friendly

Playful

Neutral

Fearful

Reactive

Aggressive

Handling & Body Sensitivity

Comfort With Being Touched On ( Select All That Apply )*

Head

Ears

Paws

Tail

Belly

Tolerance of grooming, nail trims, bathing, veterinary handling*

Any known sensitive areas or triggers (e.g., collars, harnesses, certain tools)*

Fear, Anxiety, And Reactivity

Known fears or triggers (loud noises, vacuum, cars, bikes, men with hats, umbrellas, etc.)*

Separation anxiety indicators*

Resource guarding (food, toys, people, space, resting spots) rate severity and describe*

History of biting, snapping, growling, or lunging (people or animals) describe incidents, context, and outcome*

Barking, lunging, or reactivity on walks or in new environments*

Play & Social Style

Preferred play style (rough-and-tumble, chase, gentle, independent)*

Tolerance for being mounted, body-slammed, or corrected by other dogs*

Ability to settle / calm down after excitement*

Training & Obedience History

Basic commands known (sit, stay, come, leave it, drop, heel, etc.) and reliability level*

Previous training classes or private work*

Tools currently used (flat collar, martingale, harness, head halter, prong, e-collar, etc.) and owner’s preference*

Any known training challenges or goals the owner wants addressed*

Daily Life & Routine

Typical daily schedule (walks, potty breaks, play, alone time)*

Crate / confinement tolerance and experience*

House-training status and any accidents history

Sleeping arrangements and nighttime behavior*

How the dog behaves when left alone*

Consent Liability & Signatures

I Acknowledgment that information is accurate

Consent for assessment, handling, and any necessary veterinary care in an emergency

Permission for photos/videos for business use *

Yes

No

Liability Waiver & Assumption of Risk Please read the full Liability Waiver for Reno-Tahoe Paw Retreat before submitting.

I have read and agree to the Reno-Tahoe Paw Retreat Liability Waiver, Release, and Assumption of Risk Agreement. I understand I am giving up substantial legal rights, including the right to sue.

Signature*

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Todays Date*

Month

Day

Year

Liability Waiver

bottom of page