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.
EMAIL:_______________________________
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:
DHLPP__________
Bordatella _________
Rabies__________