Medical History Form Owner's Name First Last PhoneEmail Pet's Name:Describe any medical conditions, surgeries or physical impairments and/or any physical limitations to be aware of before your dog participates in any activity?Check all that apply Arthritis Diabetes Allergies Ear/Eye Infections Hot Spots Stress-related diarrhea (colitis) Seizures If yes, how often and describe?PET PROFILEDoes your dog play with other dogs? Yes No Are there any kinds of people your dog automatically fears or dislikes?Has your dog ever growled at someone? Yes No If yes, what were the circumstances?Has your dog ever bitten anyone? Yes No If yes, what were the circumstances?Is your dog protective over food, toys and/or other objects? Yes No If yes, please explainAny history of destructive chewing? Yes No Separation anxiety? Yes No Has you dog ever climbed or jumped over a fence? Yes No Does your dog have any sensitive areas on his I her body? Yes No If yes, please explainHow does your dog react to having his I her nails clipped?Is your dog afraid of thunderstorms or any specific item or noises? Yes No If yes, please explainPhoneThis field is for validation purposes and should be left unchanged.Like Us On FacebookAppointmentsWe will do our best to accommodate your busy schedule. Please schedule an appointment today!Request AppointmentGet Directions