GUIDE DOG PUPPY VISITING FORM
Give as much information as possible about your puppy so the sitter can give it proper care. Submit this completed form and the sitter's Diary of the Visit with the puppy report you turn in to the club leaders. Be sure to explain headcollars or other specialized equipment your puppy may be using to the sitter, so they are aware of its proper use.

PUPPY SITTER'S NAME_________________________________Phone:____________

PUPPY & RAISER INFORMATION
It is customary for the puppy raiser to transport the puppy to and from the sitter’s home
Date dropped off ____________   Date & time puppy will be picked up_________________
Puppy’s Name:__________________________Breed:___________Age:____________  
Sex:     __Female__Male               Has the pup been altered?   __Yes         __No
Raiser’s Name:____________________________________Phone: ________________
Address:_____________________________Email_________________________________
Puppy’s Veterinarian___________________________________Phone:________________
If raiser will be out of town, phone number where you can be reached____________________
Call a leader in case of emergency or if a female comes into season.
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FEEDING & HABITS
Food: __Wet       __Dry      __Pro Plan Large Breed Puppy    __ Eukanuba Adult      Other brand_____________
    Number of cups per feeding _____________  Number of feedings per day__________________
    Feeding Times: Morning________ Midday________ Evening _____________


 Special feeding/watering instructions:                          

Relieving: Approximately how often?________________________
     Will pup acknowledge the need?   __Yes    __No    How?                
Puppy Sleeps:       __Crated              __Tiedown          __Roams free   Where?
HEALTH
Medical Conditions:

Medication Instructions:

TRAINING:
Circle your puppy’s level of proficiency for each command: 
Pup Does:
 On Command
 With Help
  Will Not Do
      
Pup Does:  
 On Command 
 With Help
  Will Not Do
Sit 
Down 
Stay
Let’s Go
 3
3
3
3
 2
2
2
2
 1
1
1
1
Come
Wait
Do Business 
Other
 3
3
3
3
 2
2
2
2		 1
1
1
1
  Does your puppy know its commands off leash as well as it does on leash? __Yes    __No
BEHAVIOR:





In the House:
Barking 
House trained 
Jumps on furniture
Steals food
Chewing 
Keepaway
Must be crated
Raids trash cans
Drag line  needed 
Other: 
 __Yes    __No
 __Yes    __No
 __Yes    __No
 __Yes    __No
 __Yes    __No
 __Yes    __No
 __Yes    __No
 __Yes    __No
 __Yes    __No
 In the Yard:
Filth eater
Digging
Garbage mouth
Chewing  
Keep on leash 
Other


  
__Yes    __No
 __Yes    __No
__Yes    __No
__Yes    __No
__Yes    __No


 On Outings:
Use Head Collar
Distracted by:
Afraid of:
Other:

SOCIAL OUTINGS:

Outings appropriate for my puppy:
__ 10-15 minute in-and-out only 
__ 1-2 hour quiet (restaurant, church)
__ 1-2 hour active (grocery shopping)
 __ 2+ hour quiet (on tiedown at work)
__ Pup can handle most outings
Puppy sitters take responsibility for terminating an outing when the puppy shows signs of being overwhelmed. Be sure to give the pup ample opportunity to relieve, and clean up accidents that occur. Puppy sitters understand that puppies may be crated at home for up to four hours if the outing will be inappropriate.

PUPPY’S CHALLENGING BEHAVIORS:



SUGGESTIONS FOR DEALING WITH THESE CHALLENGES:





Check List:

__Puppy coat
__Head collar & safety collar
__Leash
__Bowl(s)
__Food
 __Brush/grooming tools
__Toothbrush
__Medication
__Toys (list)  
__Tiedown 		__Kennel
__Clean-up kits
__Drag line
__Retractable leash
__Other_______________



PUPPY SITTER'S DIARY OF THE VISIT
Please use the space below to keep a diary of the puppy’s visit. List the puppy’s social outings. Tell how the pup did, both in the home and during social outings. Be honest. The pup’s raiser needs to know your experiences to help the puppy do better. Your observations can help identify areas of concern as well as highlight the puppy’s strengths. Attach extra pages if necessary and return this form to the raiser when the puppy is picked up. A copy of this form and the diary you keep will be submitted with the puppy’s monthly report.
Day 1 date:






Day 2 date:






Day 3 date:






Day 4 date:






Day 5 date:






Day 6 date:






Day 7 date:






Please use additional sheets as needed.
atl 2/2005