Please fill out the New Client form for each dog in your family. Submit this form online or print it out and bring it with you.

General Information Owner First Name: Owner Last Name: Address: City: State: TX AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN UT VT VA WA WV WI WY        Zip: Home Phone:     Work Phone: Cell Phone:     Additional Phone: Email: Emergency Contact Name: Emergency Contact Number: How did you hear about Action Pack Dog Center? Web/Google Search Local Event Action Pack Client Austin Pets Directory Community Impact Other:        Dog's Name:     Breed: Weight:     Sex: Male Female Spayed/Neutered: Yes No Color/Description: Date of Birth (estimate if unknown): Vet Clinic Name: Vet Clinic Phone Number:

Dog Personality and Behavior Information History How long have you owned your dog? Where did you get your dog (Adopted, Breeder...)? If adopted, do you have a knowledge of his/her past? Yes No Explain: Health Does your dog have any allergies? Yes No If yes, please specify: Is your dog taking any medications? Yes No If yes, please specify: Does your dog have any sensitive spots on his/her body? Yes No If yes, please specify: Training Did your dog have any formal training? Yes No If yes, where and what kind? What commands/tricks does your dog know? Is your dog crate trained? Yes No Where does he/she sleep? Is your dog house trained? Yes No Disposition Are there any kinds of people, dogs or sounds your dog fears or dislikes? (e.g. people wearing hats, big dogs, thunder, etc.): Has your dog ever bitten a person? Yes No What were the circumstances? Has your dog ever tried or succeeded in digging under or jumping over a fence? Yes No If yes, please explain: Does your dog have separation anxiety? Yes No If yes, please explain: Play Favorite toys? Favorite treats? Favorite games (e.g. fetch, tug, chase, etc.)? Please list any other information or special instructions for your dog: I have read and agree to the "Pack Rules" found on the Rules Page of the website:  (initial)   Today's Date: 9/8/2010