New Customer Enrollment

We're thrilled you found us and look forward to meeting both you and your dog!

To get started:

Fill out the New Client Enrollment Form.
Our customer service staff will call you to learn about your puppy/dog and share information about our services.
Ask your veterinarian to fax your dog’s current vaccination records to us at 510-562-0132 or email records to info@citizencanine.net, or upload vaccination records here.

Guardian's Name*
First Last
Primary Home Address*
Street Address Address Line 2 City State ZIP Code
Email Address*
Primary Phone*
What is the Best Time to Reach You?*
What Service(s) Are You Interested In? Check all that apply.*
- Daycare
- Boarding
- Training
Information About Your Pet(s)*
Please include the following for each pet: Name, Breed, Gender, Age, Weight, Spayed/Neutered.
Tell Us More About Your Pet(s)*
What your pet prefers, any health or behavioral issues, any medications, special meals, allergies etc.?
Up-to-Date Vaccines Are Required*
Please confirm that the following vaccines are up to date and then have your Veterinarian Fax (510-562-0132) or Email info@citizencanine.net records to us.
- Rabies
- Distemper
- Bordetella
- Canine Influenza
Vaccination Records
Max. file size: 2 MB.
How did you hear about us?*
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