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132 E Route 59
Nanuet, NY 10954
Dog Hill Inc
Client Information Form
Please fill out the information form as completely as possible, then click Submit.  We'll be in touch with you shortly to discuss your specific dog care requirements and how we can be of service to you.

Name                                                                                  What Type of Service Are You Interested In?                                                                      

​Email Address                                                                     What Are Your Desired Dates/Times?

Home Phone Number                                                                 

​Cell Phone Number                                                                    

Home Address                                                                    Emergency Contact Information                                      


Veterinarian's Contact Information

Breed, Size, and Color of Your Dog

Dog's Name and Age

Dog's Gender

Valid Tag or License Number

Has Your Dog Been Sprayed or Neutered?

Has Your Dog received complete immunization for DHLPP, Bordatella(Kennel cough), and Rabies?

Is Your Dog House-Broken?

Please Provide Details of Any Current or Recent Health Problems and if Your Dog is Taking Any Medication​

Is Your Dog Insured?​  If Yes, Please Provide Carrier and Policy Number

Is Your Dog Microchipped?

Please Describe Your Dog's Personality, If He or She is Well Trained, Has Ever Shown Agression Towards Other Dogs or People, Or Anything Else You Feel We Should Know

​How Did You Hear About Dog Hill?                             If Other, Please Explain