Pet caregiver and golden retriever outdoors

Contact Hearts With Peace

Dog Walking New Client Intake Form

Tell Susan about you, your dog and the routine that will help every visit go smoothly.

New Client Intake

Let's get to know your dog.

Complete the form below and Susan will follow up with you. Prefer to talk first? Call or text (281) 967-6478.

Home access note: Do not enter door, keypad or lockbox codes in this form. Susan can arrange access details with you directly.

Owner Contact Information

Primary Owner Name Phone Number Email Address Home Address Emergency Contact Name & Relationship Emergency Contact Phone

Pet Profile

Dog's Name Breed Age / Birthday Weight

Spayed / Neutered? Yes No

Medical & Vet Details

Current Medications / Dosages Allergies or Dietary Restrictions Primary Vet Clinic & Doctor Vet Phone Number Vet Address

Behavior & Walk Preferences

How does the dog react to other dogs? How does the dog react to strangers / passersby? Any fear triggers? (Loud noises, skateboards, trucks, etc.) Does the dog pull, lunge, or have any leash habits?

Is the dog allowed to receive treats during the walk? Yes No

Home Logistics

Home Entry Method (key, lockbox, keypad) Location of leash, harness, collar, and waste bags Location of towel (for wiping muddy paws) Are there other pets in the home I should be aware of when entering?

Submitting this form sends the information directly to the email configured for Hearts With Peace.