New Client Information Form

First Name * Last Name * Mobile Phone * Home/Work Phone Email Address * Pet's Name * Dog Breed: Affenchon Affenhuahua Affenpinscher Affenpoo Afghan Hound Airedale Terrier Airedoodle Akbash Dog Akita Inu Alano Espanol Alapaha Blue Blood Bulldog Alaskan Husky Alaskan Klee Kai Alaskan Malamute Alopekis Alpine Dachsbracke Alusky American Alsatian American Bandogge American Boston Bull Terrier American Bull Dogue De Bordeaux American Bull Molosser American Bull-Jack American Bulldog American Bullnese American Coonhound American Eagle Dog American Eskimo Dog American Foxhound American French Bull Terrier American Gointer American Hairless Terrier American Indian Dog American Lo Sze Pugg American Mastiff American Mastiff Panja American Pit Bull Terrier American Rat Pinscher American Staffordshire Terrier American Water Spaniel American White Shepherd Appenzell Mountain Dog Atlas Terrier Ausky Auss-Tzu Aussie-Corgi Aussiedoodle Austi-Pap Australian Bulldog Australian Cattle Dog Australian Kelpie Australian Labradoodle Australian Retriever Australian Shepherd Australian Silky Terrier Australian Stumpy Tail Cattle Dog Australian Terrier Austrian Shorthaired Pinscher Azawakh Hound Ba-Shar Bagle Hound Banter Bulldogge Barbet Bascottie Basenji Baskimo Basschshund Basset Artesian Normand Basset Hound Basset Retriever Bassetoodle Basston Bassugg BD Terrier Be-Apso Bea Griffon Bea-Tzu Beabull Beacol Beagle Beagleman Beaglier Beaglolo Beago Bearded Collie Beauceron Bedlington Terrier Belgian Groenendael Belgian Laekenois Belgian Malinois Belgian Mastiff Belgian Tervuren Belgrade Terrier Bergamasco Sheepdog Berger De Picard Bernefie Bernedoodle Bernese Mountain Dog Bich Poo Bichomo Bichon Frise Bichon-A-Ranian Biewer Biewer Yorkie Biton Black Mouth Cur Black Russian Terrier Bloodhound Blue Lacy Blue Spaniel Bluetick Coonhound Bo-Dach Bocker Bodacion Boerboel Bogle Boglen Terrier Bohemian Shepherd Bolo-chi Bolo-Tzu Bologco Bolognese Bolonoodle Bolosilk Borador Border Collie Border Terrier Border-Aussie Bordernese Bordoodle Borzoi Bosapso BoShih Boskimo Bospin Bossi-Poo Bostchon Bostie Bostillon Bostinese Boston Cattle Dog Boston Spaniel Boston Terrier Bouvier des Flandres Boweimar Bowzer Boxador Boxapoint Boxer Boxerdoodle Boykin Spaniel Braque du Bourbonnais Brat Brazilian Terrier Briard Brittany Bourbonnais Brittany Spaniel Broholmer Broodle Griffon Brottweiler Brug Brusselranian Brussels Griffon BT Walker Buggs Bukovina Sheepdog Bull Terrier Bull-Boxer Bull-Pei BullBoxer Bullhuahua Bullmasador Bullmastiff Bullmatian Bulloxer Bully Basset Bully Bordeaux Bullypit Bushland Terrier Cadoodle Cairanian Cairicockers Cairland Terrier Cairmal Cairn Terrier Cairnese Cairnoodle Canaan Dog Canary Dog Cane Corso Italiano Canis Panther Canoe Dog Cao da Serra de Aires Cao de Castro Laboreiro Cao de Fila de Sao Miguel Cao Dos Mourey Caravan Hound Cardigan Welsh Corgi Care-Tzu Carkie Carlin Pinscher Carnauzer Carolina Dog Carpathian Sheepdog Catahoula Bulldog Cattle Collie Dog Caucasian Ovtcharka Cav-A-Malt Cav-A-Mo Cava-Chin Cava-Corgi Cava-lon Cava-shell Cava-Tzu Cavachon Cavalier King Charles Spaniel Cavanese Cavapom Cavapoo Cavaton Cavestie Cavottish Central Asian Ovtcharka Cesky Fousek Cesky Terrier Cheeks Cheenese Cherokee Monarch Chesa-Poo Chesador Chesapeake Bay Retriever Chestie Chi Apso Chi-Chi Chi-Chon Chigi Chihuahua Chilier Chimation Chin Crested Chin-Ocker Chin-Pin Chin-wa China Jack Chinaranian Chineranian Chinese Chongqing Dog Chinese Crested Chinese Frise Chinese Imperial Dog Chinook Chion Chipin ChiPoo Chiweenie Chizer Chonzer Chorkie Chow Chow Chug Chussel Clumber Spaniel Cluminger Spaniel Cock-A-Mo Cock-A-Tzu CockaBichon Cockalier Cockapin Cockapoo Cocker Pug Cocker Spaniel Cocker-Pei Cocker-Ton Cockeranian Cockinese Cogol Cojack Collie Colonial Cocker Spaniel Corgi Basset Corillon Corkie Cosheltie Coton De Tulear Coton Eskimo Coton Tzu Coton-Beagle Cotonese Cotralian Crested Havanese Crested Malt Crested Schnauzer Crestoxie Cretan Hound Croatian Sheepdog Crustie Curly Coated Retriever Czechoslovakian Wolfdog Dach-Griffon Dachshund Dakota Shepherd Dakotah Shepherd Dalmatian Dameranian Dandie Dinmont Terrier Daniff Danish Broholmer Danish Swedish Farm Dog Daug Deutscher Wachtelhund Doberman Pinscher Dobsky Dogo Argentino Dogue Brasileiro Dogue de Bordeaux Doodle Doodleman Pinscher Dorgi Dorkie Dorset Olde Tyme Bulldogge Double Doodle Doubull-Mastiff Doxie Scot Doxie-Chon Doxie-Pin Doxle Drever Dualanese Dutch Shepherd Dutch Smoushond East European Shepherd Eng-A-Poo Enga-Apso Engachon Enganese Engatzu Spaniel English Boodle English Boston Bulldog English Bull-Walker English Bulldog English Bullweiler English Cocker Spaniel English Coonhound English Foxhound English King English Mastweiler English Setter English Shepherd English Speagle English Springer Spaniel English Toy Chin Spaniel English Toy Cocker Spaniel English Toy Griffon English Toy Spanese English Toy Spaniel Entlebucher Sennenhund Eskapoo Eskifon Eskijac Eskland Estonian Hound Eurasier Euro Mountain Sheparnese Ewokian Faux Frenchbo Bulldog Field Spaniel Fila Brasileiro Finnish Hound Finnish Spitz Flat Coated Retriever Fo-Chon Fo-Tzu Foodle Fourche Terrier Foxingese Foxker Foxton Foxy Rat Terrier Foxy Russell Free-Lance Bulldog French Brittany French Bulldog French Bullhuahua French Pin French Spaniel French Weenie Frenchie Pug Frenchie-Pei Frenchnese Frengle Galgo Espanol German Hunt Terrier German Longhaired Pointer German Malinois German Pinscher German Sheeppoodle German Shepherd German Shorthaired Lab German Shorthaired Pointer German Spitz German Wirehaired Pointer Giant Maso Mastiff Giant Schnauzer Giant Schnoodle Glechon Glen of Imaal Terrier Goberian Golden Cavalier Golden Irish Golden Labrador Golden Mountain Dog Golden Newfie Golden Pei Golden Pyrenees Golden Retriever Goldendoodle Goldmaraner Goldmation Gollie Gordon Setter Great Bernese Great Dane Great Pyredane Great Pyrenees Greater Swiss Mountain Dog Greenland Dog Greyhound Griffichon Griffonese Griffonland Griffonshire Hairless Khala Harrier Hava-Apso Hava-Jack Hava-Welsh Hava-Wheat Havachin Havachon Havallon Havamalt Havanese Havanestie Havapeke Havashire Havashu Havaton Hawaiian Poi Dog Hellenikos Ichnilatis Hellenikos Poimenikos Highland Maltie Hokkaido Hovawart Ibizan Hound Icelandic Sheepdog Imo-Inu Irish Doodle Irish Mastiff Irish Red and White Setter Irish Saint Irish Setter Irish Staffordshire Bull Terrier Irish Terrier Irish Troodle Irish Wolfhound Italian Greyhound Italian Greyhuahua Italian-Bichon Ja-Chon Jacairn Jack Chi Jack Russell Terrier Jack-A-Bee Jack-A-Poo Jack-A-Ranian Jack-Rat Terrier Jackie-Bichon Jafox Jaland Japanese Spaniel Japanese Spitz Japeke Japillon Japug Jarkie Jatese Jatzu Jindo Jug Kangal Karakachan Karelian Bear Dog Karst Shepherd Kashon Keeshond Kemmer Feist Kerrblushcnauz Kerry Blue Terrier Kerry Wheaten Kimola King Cavrin King Charles Yorkie King Schnauzer King Shepherd Kobetan Komondor Kooikerhondje Koolie Kunming Dog Kuvasz Kyi Leo La Pom La-Chon Lab-Pointer LabAire Labany Labbe Labloodhound Labmaraner Labradinger Labradoodle Labrador Husky Labrador Retriever Labralas Labrottie Lagotto Romagnolo Lakeland Terrier Lancashire Heeler Landseer Newfoundland Large Munsterlander Larson Lakeview Bulldogge Leonberger Lha-Basset Lha-Cocker Lhaffon Lhasa Apso Lhasa-Coton Lhasa-Poo Lhasalier Lhasanese Lhatese Lithuanian Hound Llewellin Setter Louisiana Catahoula Leopard Dog Lowchen Lundehund Mal-Shi Malchi Malteagle Maltese Malti Poo Malti-Pin Maltichon Maltipom Manchester Terrier Maremma Sheepdog Markiesje Mastador Masti-Bull Mastiff Mauxie Mauzer Meagle Mi Ki Mini Australian Shepterrier Miniature Australian Bulldog Miniature Australian Shepherd Miniature Australian Shepterrier Miniature Bulldog Miniature English Bulldach Miniature Fox Terrier Miniature French Bull Terrier Miniature Littlefield Sheepdog Miniature Pinscher Miniature Poodle Miniature Schnaupin Miniature Schnauzer Miniature Schnauzzie Miniature Schnoxie Miniboz Minnie Jack Mioritic Sheepdog Morkie Moscow Watchdog Mountain Bulldog Mountain Cur Mountain Feist Mountain Mastiff Mountain View Cur Mucuchies Mudi Muggin Muscle Mastiff Native American Indian Dog Neapolitan Mastiff Nebolish Mastiff Nekita New Guinea Singing Dog New Zealand Huntaway Newfoundland Norfolk Terrier Nortese Norwegian Buhund Norwegian Elkhound Norwich De Tulear Norwich Terrier Nova Scotia Duck Tolling Retriever Old Anglican Bulldogge Old English Sheepdog Olde Boston Bulldogge Olde Bulldog Olde English Bulldogge Olde Victorian Bulldogge Ori Pei Otterhound Papastzu Paperanian Papi-Poo Papichon Papigriffon Papillon Papimo Papitese Papshund Parson Russell Terrier Patterbea Patterdale Terrier Patton Terrier Peagle Peek-A-Pom Peka-A-West Pekalier Pekarin Peke-A-Boo Peke-A-Chon Peke-A-Pap Peke-A-Pin Peke-A-Poo Peke-A-Tese Pekehund Pekingese Pembroke Welsh Corgi Perdiguero de Burgos Peruvian Inca Orchid Petit Basset Griffon Vendeen Pharaoh Hound Pineranian Pinny-Poo Plott Hound Pointer Polski Owczarek Nizinny Pom Terrier Pom-A-Nauze Pom-A-Pug Pom-Coton Pom-Shi Pom-Silk Pomapoo Pomchi Pomeagle Pomeranian Pomerat Pomimo Pomston Poo-Shi Poo-Ton Poochin Poochis Pooda Houla Poogle Poolky Pootalian Poovanese Porcelaine Portuguese Hound Portuguese Water Dog Poshies Prazsky Krysarik Pug Pug-A-Poo Pug-Coton Pug-Zu Pugairn Pugalier Pugese Puggat Puggit Puggle Pughasa Puginese Pugland Pugottie Pugshire Puli Pumi Pushon Pyredoodle Rafeiro do Alentejo Raggle Raibs Suns Rashon Rat Terrier Rat-a-pap Rat-Cha Ratese Ratshi Terrier Ratshire Terrier Rattle Rattle Griffon Redbone Coonhound Rhodesian Ridgeback Roman Rottweiler Rottaf Rotterman Rottweiler Rus-A-Pei Russian Spaniel Russian Toy Terrier Rustralian Terrier Saarlooswolfhond Saint Berdoodle Saint Bernard Saint Dane Saluki Samoyed Sarplaninac Schapso Schip-a-pom Schipese Schipper-Poo Schipperke Schnau-Tzu Schneagle Schnekingese Schnese Schnocker Schnoodle Schnu Schweenie Scoland Terrier Scoodle Scorkie Scotchi Scotchon Scotinese Scotti Apso Scottish Cocker Scottish Deerhound Scottish Terrier Scottish-Skye Terrier Sealyham Terrier Shairn-Inu Shar Pei Sharbo Sharmatian Sharp Eagle Sheepadoodle Shel-Aussie Shelchon Shelestie Shelillon Sheltidoodle Sheltie Inu Shepadoodle Sheprador Shetinese Shetland Sheepdog Shi-Pom Shiba Inu Shibos ShiChi Shichon Shiffon Shih Apso Shih Tzu Shih-Mo ShihPoo Shikoku Shiloh Shepherd Shinese Shiranian Shocker Shorgi Shorkie Shug Sibercaan Siberian Husky Siberian Indian Dog Silkchon Silken Windhound Silkese Silkin Silkinese Silkland Terrier Silkshund Silky Cairn Silky Cocker Silky Coton Silky Jack Silky Pug Silky Terrier Silky Tzu Silky-Lhasa Silky-Pin Silkyhuahua Silkytie Silkzer Skilky Terrier Skip-Shzu Skye Terrier Skypoo Sloughi Slovensky Cuvac Smooth Fox Terrier Sniffon Snorkie Soft Coated Golden Soft Coated Wheaten Terrier Soft Coated Wheatzer Soft Coated Woxer South Russian Ovtcharka Spanador Spangold Retriever Spanish Mastiff Spanish Water Dog Spantriever Spinone Italiano Springerdoodle St Weiler Stabyhoun Staffordshire Bull Terrier Standard Poodle Standard Schnauzer Sussex Spaniel Swedish Vallhund Swissneese Taco Terrier Tamaskan Dog Tenterfield Terrier Terri-Poo Texas Heeler Thai Ridgeback Tibetan Mastiff Tibetan Spaniel Tibetan Terrier Titan Bull Dogge Torkie Tornjak Tosa Inu Toxirn Toy Fox Pinscher Toy Fox Terrier Toy Poodle Toy Poxer Toy Rat Doxie Treeing Walker Coonhound Tzu Basset Ultimate Mastiff Valley Bulldog Victorian Bulldog Vizsla Wauzer Wee-Chon Weeranian Weimaraner Weimardoodle Wel-Chon Welsh Cardigan Corgi Welsh Springer Spaniel Welsh Terrier Welshund Weshi West Highland Doxie West Highland White Terrier West of Argyll Terrier Westie-Laso Westiepoo Wetterhoun Whippet Whoodle Wire Fox Pinscher Wire Hair Snauzer Wire-Poo Wirehaired Fox Terrier Wirehaired Pointing Griffon Wirehaired Vizsla Wirelsh Terrier Wowauzer Xoloitzcuintli Yo-Chon Yoranian Yorkelties Yorkie Pin Yorkie Poo Yorkie Russell Yorkie-Apso Yorkie-ton Yorkillon Yorkinese Yorkshire Terrier Yorwich Cat Breed: Domestic Shorthair Domestic Longhair Maine Coone Persian Himalayan Date of Birth* Pet's Gender* Male Female Breeding Status* Dysfunctional Fully Functional Neutered Spayed Unable to Breed Approximate Weight * Personality* Aggressive with animals Aggressive with people Barker Biter Calm Chews Nervous Are there any medical conditions we should be aware of?* Blind Deaf Diabetic Epileptic Heart Condition None Is the coat matted?* No Yes Veterinary Clinic Name * Veterinary Clinic Phone * Veterinary Clinic City * Veterinary Clinic State * Is your pet's rabies vaccination up to date? (Mandatory)* No Yes When does your pet's rabies vaccination expire?* Is your dog's distemper vaccine up to date? (Mandatory/ Dogs Only) * Yes No When does your dog's distemper vaccine expire?* Has your dog been administered the Bordatella vaccine in the past year? (Optional)* Yes No Comments/Special Instructions *

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