Form

Individual Animal Profile

Perforated page — tear out & copy

From ch04.md (lines 141-216).

One profile per dog, filled in once at intake.

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Fill the form on this page directly in your browser. The form is fully interactive.
Click "Print / Save as PDF" to print the form to paper or save a PDF copy for your records.
Download the DOCX for an editable Microsoft Word version you can email, print, or archive.
Review the source chapter in the book for full context: see the chapter reference in the page header.

Dog details

Dog's name*

Breed

Age

Sex

Neuter status

Microchip number

Date of birth (if known)

Colour/markings

Owner details

Name

Address

Phone

Emergency contact

Veterinary details

Usual vet practice

Vet name

Phone

Insurance company

Policy number

Medical history

Current conditions

Current medications

Allergies

Previous surgeries

Behavioural notes (anxieties, triggers)

Diet

Food brand and type

Daily amount

Meals per day

Treats allowed

Medical diet required

If yes, details

Vaccination history

Distemper: Date / Expiry

Hepatitis: Date / Expiry

Parvovirus: Date / Expiry

Leptospirosis: Date / Expiry

Kennel cough (if required): Date / Expiry

Rabies (if applicable): Date / Expiry

Titre test result (if used in lieu of vaccine)

Parasite treatment

Flea treatment: Date / Product

Worming treatment: Date / Product

Tick treatment: Date / Product

Consent (signed by owner)

Veterinary treatment in emergency

Administration of medication

Photo/video for marketing

Mixing with other dogs

Sharing a kennel/room with same-household dog

Other (specify below)

Other details

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