Questionnaire

To be completed prior to your dog/s boarding or daycare

Doggy Haven

024 Galway Road, Rangeview, Krugersdorp, Johannesburg

Mobile: +27 83 390 3590 / E-mail: info.doggyhaven@gmail.com

Website: www.doggyhaven.co.za

QUESTIONNAIRE TO BE COMPLETED PRIOR TO YOUR DOG/S BOARDING OR DAYCARE

Personal Information

First name:

Last name:

Address, city and postal code:

Contact number:

Second contact number:

Emergency contact number:

E-mail address:

Dog Information

Dog 1

Dog Name:

Dog Breed:

Dog Age:

Dog Sex - Male /Female:

Is your dog neutered or spayed? If yes, what year was it done?

Dog 2

Dog Name:

Dog Breed:

Dog Age:

Dog Sex - Male /Female:

Is your dog neutered or spayed? If yes, what year was it done?

Dog 3

Dog Name:

Dog Breed:

Dog Age:

Dog Sex - Male /Female:

Is your dog neutered or spayed? If yes, what year was it done?

Dog 4

Dog Name:

Dog Breed:

Dog Age:

Dog Sex - Male /Female:

Is your dog neutered or spayed? If yes, what year was it done?

Health Information

Does your dog/s have any health problems we need to be aware off? If so, please indicate what condition and are there any medications your dog/s needs to receive?

Are all your dog/s injections up to date? Please may we have a copy of your dog/s vet book as proof.

Daily Routine

How many times a day does your dog/s gets a meal and what time?

Where does your dog/s sleep at night?

When is the last time at night +/- when your dog/s does his / her / their business outside?

What time does your dog/s +/- awake in the morning and need to go out for the first time?

Additional Information

Is there anything else we should be aware off about your dog/s whilst he / she / they are in our care?

Please indicate if we can wash your dog when dirty, if yes, please provide own shampoo. No shampoo, no wash. Please note that dogs will only be washed after at least a week's stay with us.

Please write down all the words your dog/s knows and understands, in other words how you talk to him / her / them.

Do you have insurance for your dog/s? If yes, please stipulate the insurance company. Insurance on your dog/s is always recommended, but if not, please make yourself familiar with our disclaimer and waiver form.

Veterinarian Information

Vet name:

Vet contact number:

Vet address:

Signature

Please sign below (required for printing and emailing):

Doggy Haven | Questionnaire | April 2026

Signature is required before printing or emailing. Data will be cleared when you close this page.