Book Now - Kingsbury Canines

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Your Name *

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Last

Email *

Which Services

Board and Trains
Private Lessons
Boarding
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Phone *

Preferred Drop off *

Date

Time

Preferred Pick up

Date

Time

Address *

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City

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Zip Code

Information About Your Dog

Dog's Name *

Dog's Age *

Breed *

Dog's Gender

Is your dog aggressive toward humans? *

Yes
No
Other

Other (please describe): *

Is your dog aggressive toward other animals? *

Yes
No
Other

Other (please describe): *

Does your dog have a history or record of biting? *

Yes: Please provide additional details on history/record of biting. *

Is your dog crate trained? *

Is your dog up to date on the following shots and medications? (Check if yes) *

Rabies
Bordetella
Distemper
Heartworm
Flea/Tick Treatment

You will need to provide a current record of treatment upon the initial meeting prior to be accepted as a client.

Is your dog spayed/neutered? *

Your Dog's Health

Feeding Instructions

Please list any allergies your dog has, the reaction, and treatment.

your Is Any

Please list all medications, dosages, and the times your pet receives each medication.

Any additional comments or notes?

Terms & Agreement *

I agree and accept the terms.

I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate, and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts in this document is cause for denial of services or immediate termination of current services, regardless of the timing or circumstances of discovery. In the event that service is terminated, payment will still be owed in full.

I understand that the submission of this application does not guarantee services.

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