Client / Dog Information

Handler/Owner:  _______________________________
Address:  _______________________________
City, ST. Zip Code_________________________
Phone:     _______________________________
Cell phone:_______________________________
A lot of our communication at Desert Sage is done thru the email so please let us know if you
don’t check it frequently.

In case of emergency please contact:_________________________________________

Any dog issues you think we might need to know about?

Any handler issues?  (Loss of peripheral vision or physical restrictions are some examples)

Dog’s Name: ________________________________
Breed:  _____________________________________
Age:  _______________

Veterinarian name and number: _________________
2 nd choice Veterinarian:_______________________

Most Recent Vaccinations were given on what date:
Bordatella _________