Informational Sheet

Please read and circle yes or no for the following questions and on a yes answer provide a brief description.

1. Human aggression   yes____      no_____ _________________________________________________
2. Dog [animal] aggression  yes____  no____ __________________________________________________
3. Fear Bitter  yes____  no____
   __________________________________________________
4. Separation anxiety  yes____  no______ _________________________________________________
5. Escape Artist  yes_____    no____ __________________________________________________
6. Jumping [inside/outside kennels/fences]   yes_____  no____  ___________________________________________________
7. Climbing [inside/outside kennels/fences]  yes_____ no____ ___________________________________________________
8. Excessive barking  yes______   no______
   ____________________________________________________
9. Timid or Aggressive behavior  yes____  no____ ____________________________________________________
10. Chewing or Clawing   yes____  no_____ ____________________________________________________

We will take every precaution for the health and welfare of you dog (s) while in our care.