Baltimore Dog Walking Intake Form

Thank you for choosing Baltimore Dog for your pet’s walking services. We are dedicated to keeping your pet happy and healthy. Our goal is to become your pet’s best friend.

To ensure we provide the best care, please fill out this form completely and clearly before your consultation appointment. Doing so will speed up the registration process and give us the information we need to understand your pet’s needs better.

By providing detailed information now, you help us prepare effectively. As a result, we can offer care tailored to your pet’s specific needs. We appreciate your cooperation and look forward to working with you and your furry friend.

General Info - Step 1 of 5

About You

Name *

First

Last

Email *

Cell Phone *

Home Phone

Where did you hear about Baltimore Dog? *

• Facebook
• Instagram
• Nextdoor
• Friends/Family
• Somewhere Else

Please provide a name. *

Please specify. *

Instagram Handle (So we can tag your pet! @baltimore.dog)

(If applicable)

Address *

Address Line 1

Address Line 2

City

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Zip Code

Access instructions. *

If entry will be made by key, Baltimore Dog requires 2 copies before the first scheduled date.

Emergency Contact Info

Contact Name *

Please provide a local contact

Relationship *

Please provide a local contact

Contact Phone *

Does your emergency contact have a key? *

• Yes
• No

Next

About Your Pet

Number of Pets *12345

Name *

Birthday *

Breed *

Sex *MaleFemale

Neutered/Spayed *YesNo

Name (2)

Birthday (2)

Breed (2)

Sex (2)MaleFemale

Neutered/Spayed (2)YesNo

Name (3)

Birthday (3)

Breed (3)

Sex (3)MaleFemale

Neutered/Spayed (3)YesNo

Name (4)

Birthday (4)

Breed (4)

Sex (4)MaleFemale

Neutered/Spayed (4)YesNo

Name (5)

Birthday (5)

Breed (5)

Sex (5)MaleFemale

Neutered/Spayed (5)YesNo

Is/are your dog(s) reactive toward humans? *

• Yes
• No
• Other

Other (Please Specify):

Is/are your dog(s) reactive toward other animals? *

• Yes
• No
• Other

Other (Please Specify):

Does/do your dog(s) have a history or record of biting? *

• Yes
• No
• Other

Other (Please Specify):

Is/are your dog(s) comfortable for car rides? *

• Yes
• No
• Other

Other (Please Specify):

Is/are your dog(s) fully house trained? *

• Yes
• No
• Other

Other (Please Specify):

Is/are your dog(s) fully leash trained? *

• Yes
• No
• Other

Other (Please Specify):

Has/have your dog(s) been formally trained off leash? *

• Yes
• No
• Other

Other (Please Specify):

Is/are your dog(s) fully crate trained? *

• Yes
• No
• Other

Other (Please Specify):

Is/are your dog(s) up to date on the following shots and medications? (Check if yes) *

• Rabies
• Bordetella
• Distemper
• Heartworm
• Flea/Tick Treatment
• All
• Not Fully Up To Date

You will need to provide a current record of treatment upon the initial meeting prior to be accepted as a client.

Not Fully Up To Date (Please Specify):

Dog Walking Service *

• 15min visit
• 30min visit
• 1hr visit
• 2hr+ visit
• Mix & Match

Baltimore Dog is happy to mix & match services, days, times, & the number of visits to accommodate the perfect schedule for your dog(s).

Mix & Match (Please Specify):

Walk Schedule *

• Monday
• Tuesday
• Wednesday
• Thursday
• Friday
• Saturday
• Sunday
• Monday-Friday
• Multiple Visits Per Day

Time Frame *

• Morning (7am-11am)
• Afternoon (12pm-4pm)
• Evening (5pm-8pm)
• Night (9pm-12am)
• Multiple Times Per Day

Visits Per Day1234

Start Date:

Veterinarian / Animal Clinic

Name

Location

Phone Number

Location of Supplies / Gear

Leash(s)

Collar(s)

Crate(s)

Food & Water Bowl Locations

Waste Bags

Waste Disposal Container

Feeding (Optional)

Food Type & Location

Meals Per Day

Amount Per Meal

Dietary Restrictions or Allergies

Medication (Optional)

Name

Dosage

Frequency Per Day

Next

Pet Instructions (Optional)

Instructions for when walker arrives for walks.

Preferred walking route.

Any specific routes or areas to avoid.

Behavioral considerations (e.g. leash aggression, fears, prey drive, etc).

Instructions for how to leave your dog at the end of visit.

Any other important information we need to know (medical conditions, past injuries, phobias, likes and dislikes, restricted areas in house, crating instructions, history of escaping or trying to escape, etc.)?

Next

About Your Home (Optional)

If there is a home security system to arm/disarm:

1. Where is the security system located?

2. Alarm code and any additional keys to enter before or after entering the code.

3. How long does the walker have before or after the alarm is triggered?

Where do you want your dog walker to park when they come to walk your dog?

Next

Terms & Agreement *

• I agree & accept the terms.

I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate, and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts in this document is cause for denial of services or immediate termination of current services, regardless of the timing or circumstances of discovery. In the event that service is terminated, payment will still be owed in full. I understand that the submission of this application does not guarantee services.

Electronic Signature *

Today's Date *

Submit