INTAKE FORM

Intake Form

Owner and Contact Information

Owner's Full Name

Preferred Name / Pronouns

Address

City

State

Zip

Primary Phone

Secondary Phone

Email

How did you hear about us?

Emergency Contacts

Please provide at least two people authorized to pick up your dog if you are unavailable. They must be reachable on short notice.

Contact 1 Name

Relationship

Phone

Contact 2 Name

Relationship

Phone

Veterinarian Information

Veterinary Clinic Name

Veterinarian's Name

Clinic Phone

After Hours/ Emergency Phone

Do you authorize Turning Points staff to seek emergency veterinary care if you cannot be reached?

Yes

No

If NO, please provide instructions of what to do in case of emergency.

About Your Dog

Dog's Full Name

Dog's Nickname / Call Name

Dog's Date of Birth or Estimated Age

Breed(s)

Color / Markings

Weight (lbs.)

Sex

Male

Female

Spayed / Neutered?

Male

Female

If altered, approx. date

Vaccination Status (current records required at enrollment)

RABIES

Yes

No

Date / Due Date

DHPP (Distemper / Parvo)

Yes

No

Date / Due Date

BORDETELLA

Yes

No

Date / Due Date

LEPTOSPIROSIS (recommended)

Yes

No

Date / Due Date

CANINE INFLUENZA (recommended)

Yes

No

Date / Due Date

FLEA / TICK PREVENTION

Yes

No

Product / Frequency

Current Medications or Supplements (include dose and frequency):

Known allergies and medical conditions:

Personality and Daily Routine

In 3 - 5 words, describe your dog's personality:

Typical Saturday schedule (morning, routine, meals, nap times, activity level, evening):

Typical Sunday schedule (note differences from Saturday, if any):

How does your dog typically respond to a new environment on first arrival?

Relaxed and curious

Cautious but recovers quickly

Anxious or shut down

Excited, difficult to settle

Notes on arrival behavior:

Play Style

Has your dog ever become overstimulated or unable to self-regulate in a play group?

Yes

No

Unsure

If yes, please describe:

Deos your dog have established play partners? Describe that relationship:

7. Engery Level and Exercise Needs

Overall energy level:

Low Content to nap, minimal drive to initiate

Moderate Active in play, settles well after exercise

High Needs significant daily physical and mental outlet

Very High Rarely fully settles, persistent drive to move or work

Hours of sleep / rest day (approx):

Average daily exercise:

Favorite activities (walk, fetch, sniff work, swimming, training, etc.)

Resource Guarding

Resource guarding is a normal canine behavior that ranges in intensity. Accurate reporting helps us place dogs in appropriate groups.

Describe the guarding behavior observed (stiffening, growling, snapping, biting):

Has a person or another dog been bitten during a guarding episode?

Yes

No

If yes, describe:

Flight and Bite History

We ask for complete and honest history here. A fight or bite history does not disqualify a dog. It helps us understand thresholds, triggers, and appropriate group placement.

Has your dog been involved in a fight with another dog?

No

Yes (Please complete this section below.)

Approximate total number of fights:

1

2 to 3

4 to 10

Too many to count

Tag How many of those fights resulted in injury to either dog?

None

One

More than one

Every fight involved injury

Did any injury require veterinary care?

Yes

No

Describe injuries sustained (punctures, lacerations, care required):

If Other, please describe:

Has your dog ever bitten a person?

Never

Yes

If yes, describe the circumstance, severity (skin contact, puncture, bruising), and whether medical care was needed:

Additional Behavior Context

Is your dog comfortable being handled by unfamiliar people (restraint, collar grab, body touching)?

Yes, without issue

Somewhat, needs warming up

No, this is a challenge

Notes:

Has your dog previously attended daycare, a training class, or a play group?

Yes

No

If Yes, where?

For how long?

How did that experience go?

Has your dog received formal training? Describe the approach used.

Single Does your dog have experience with an electric fence, or have they ever worn an e-collar?

Yes

No

If Yes, please describe:

Is there anything else we should know to set your dog up for success on their first day?

Agreement and Authorization

By signing below, I confirm that the information on this form is accurate and complete. I understand that withholding behavioral history, including fight or bite history, may result in immediate removal from the program. I authorize Turning Points staff to photograph and evaluate my dog, make reasonable management decisions during the program day, and seek emergency veterinary care if I cannot be reached. I understand that not all dogs are appropriate for group enrichment programs, and placement decisions rest with Turning Points staff. your text

Owner Signature

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

Printed name

Dog's name

Date

Month

Day

Year

INTAKE FORM

Owner and Contact Information

Emergency Contacts

Veterinarian Information

About Your Dog

Personality and Daily Routine

Play Style

7. Engery Level and Exercise Needs

Resource Guarding

Flight and Bite History

Additional Behavior Context

Agreement and Authorization