Has your dog been spayed or neutered?

# 72404

4-H Guide Dog

RECORD BOOK INSERT

Information About Your Dog

Dog00 Name Tattoo Sex M / F Dog00 current age Whelp date Breed 00/font> German Shepard 00/font> Golden Retriever 00/font> Labrador Retriever 00/font> Labrador Golden Crossbred 00/font> Black 00/font> Black 00/font> Yellow 00/font> Yellow Date received from Guide Dogs for the Blind, Inc. Returned to Guide Dogs for the Blind, Inc.? Y / N If yes, give date

Vaccination Record and Dates

(Record those administered while the dog was in your care) Date

D A2 P P (Distemper, Adenovirus type 2 {hepatitis}, Parainfluenza, Parvovirus Rabies Other Other

Parasite Control Records

(Record species of parasite and veterinary treatment, if any, as well as any preventives given)

Type / Species Product Used Dates or Frequency Internal External

Other Health Information

Has your dog been spayed or neutered? Y / N If yes, give date Has your dog had its hips radiographed? Y / N If yes, give date Female Dogs only: Has your dog been in season yet? Y / N If yes, give dates to to

Training and Socialization Record

Training

Type of training equipment currently in use on your dog 00/font> Flat Collar 00/font> Training Collar 00/font> Head Collar 00/font> other Rate dog00 proficiency at the commands listed. Use rating below 0 = not introduced 1 = will not do 2 = does occasionally 3 = does 陆 the time 4 = does most of the time 5 = does all the time Responds to name Sit Off Let00 go Okay Stay That00 enough Come (on leash) Kennel Do your business Come (off leash, enclosed area) Wait Down Stand

Socialization

Rate do00 reaction to the situations listed. Use the ratings below. E = Excited C = Calm U = Uneasy F = Frightened ? = Don00 know Meeting and greeting men Dogs Meeting and greeting women Cats Meeting and greeting children / babies Livestock Crowds of people Other animals People on crutches Loud, sudden noise People carrying parcels Machinery noise Wheelchairs Thunderstorms / fireworks Bicycles Trucks Shopping carts / strollers Appliances Skateboards / roller skates Fuel / exhaust odors Balls / toys Restaurants Overhead distractions (awnings, balloons, etc) Elevators Heavy traffic Up & down stairs (open) Riding in cars Surfaces (slick floors, grates, etc) Riding on buses Other

Labor Record

Record the hours spent during each month, week, etc., on the activities listed.

Period (mo., week, etc.) Training Socializing Exercising Grooming TOTAL TOTALS

Activity/Socialization Record

Record the special activities you did or the places you took your dog to socialize it. List each under the appropriate week of the month.

Month week one week two week three week four

Activity/Socialization Record, continued

Record the special activities you did or the places you took your dog to socialize it. List each under the appropriate week of the month.

Month week one week two week three week four

Activity/Socialization Record

Record the special activities you did or the places you took your dog to socialize it. List each under the appropriate week of the month.

Month week one week two week three week four

Activity/Socialization Record, continued

Record the special activities you did or the places you took your dog to socialize it. List each under the appropriate week of the month.

Month week one week two week three week four

10-18-05

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