WVMC DAYCARE APPLICATION

Transcription

1 WVMC DAYCARE APPLICATION WELCOME to WVMC S STAY and PLAY facility. We are delighted you have chosen us for your pets recreational and fun filled needs. The following informational packet is essential to our application process, and must be completed prior to your scheduled evaluation. Our team will review the packet with you, and answer any questions you may have. This packet contains the following material: Owner and Pet Information Your Pets Veterinary and Medical Information Personality and Behavior Information Medical Treatment Form Service Agreement Owner Information: Name: Address: City, State, Zip: Primary Phone: Secondary Phone: Is this your pets first experience in daycare? Yes No If No, please tell us how long your pet has been involved in a daycare setting, and how your pets experience has been. How did you hear about us, and how can our facility best meet your needs? Pets Information: Pets Name: Male/Female (Circle) Breed: Spayed/Neutered: Yes/No (Circle) Microchip: Yes/No ID# Brand: EMERGENCY CONTACT INFORMATION: In case of an emergency what is your preferred method of communication? Work # Cell # Please provide (2) regular contacts that are authorized to drop off and pick up your pet(s) Name: Name: Relationship: Phone: Relationship: Phone: Alternate Contact Information in the event you cannot be reached: Name: Relationship: Phone:

2 MY PETS VETERINARIAN INFORMATION We take our pets to : My Primary Veterinarian Is Dr. Location: Phone: To keep all our pets safe and healthy, our vaccination, yearly physical exam, and negative fecal test requirements are listed below. You must include your pets vaccination record along with this packet. Please your pets vaccination records to infostaynplay@wrightvet.com or have a copy of your pets vaccination record with you upon your scheduled evaluation. PLEASE NOTE: WVMC RESERVES THE RIGHT TO REFUSE ENTRY INTO DAYCARE FOR PETS WHO DO NOT HAVE THE NECESSARY DOCUMENTATION FOR THE REQUIRED VACCINATIONS, A CURRENT PHYSICAL EXAMINATION PERFORMED WITHIN THE LAST YEAR, APPEAR SICK UPON ADMISSION, OR FLEA INFESTED. Required Vaccinations and Testing information listed below and why they are required: Rabies Vaccination - Required by law and can be fatal to animals and humans Canine Distemper A virus that affects a dog s respiratory, gastrointestinal, respiratory and central nervous systems. Easily passed from dog to dog through direct contact with fresh urine, blood or saliva. Sneezing, coughing and sharing food and water bowls are all possible ways for the virus to be passed on. Canine Influenza - Canine influenza is transmitted from dog to dog by respiratory secretions (i.e. coughing, sneezing, and barking). All dogs are susceptible to the virus at any time but dogs in restricted spaces (like shelters, boarding kennels, day care, etc.) are at a much higher risk. (Must have a series of 2 vaccines completed) Bordetella The reason this disease seems so common, and is even named "Kennel Cough is that wherever there are numbers of dogs confined together in an enclosed environment, such as a kennel, animal shelter, or indoor dog show, the disease is much more likely to be spread. Conversely, if you plan to have your dog use boarding, grooming and daycare facilities, remember to vaccinate a few weeks prior to potential exposure to allow full protective immunity to build up. Fecal Examination Fecal tests determine if your pet has intestinal parasites such as roundworms, hookworms, whipworms, coccidia and giardia. Humans and pets can become exposed through contamination. Year round parasite control is highly recommended. Leptospirosis: Leptospirosis is a zoonotic disease, which means it can be spread from animals to people. Common risk factors for leptospirosis in dogs residing in the United States include exposure to wild animals, farm animal species, even if in the backyard; and contact with rodents or other dogs. Currently available vaccines effectively prevent leptospirosis and protect dogs for at least 12 months. Annual vaccination is recommended. Recommended but NOT Required: Lyme Vaccination: The first line of defense against Lyme (and all the other tick-borne diseases) is a rigorous tick control program that makes use of effective monthly spot-on products. The Lyme vaccine does not provide complete protection against the disease, but is still worth considering when the risk of infection is high.

3 TELL US ABOUT YOUR DOG: PLAYGROUP COMPATABILTIY AND PERSONALITY INFORMATION Pets Name: Breed: Approx. Age: Spayed/Neutered Yes/No How long have you had your pet? How old was your pet when you first acquired him/her? Where did you obtain your pet? ACTIVITY & BEHAVIOR (Circle one) Is your pet allowed to roam free in the home? Supervised Unsupervised Is your pet allowed to run in a fenced yard? Supervised Unsupervised Outside unleashed but supervised? Yes No Does your pet have any current medical conditions or restrictions? Yes No If yes, describe and list any current medications for the condition Please list flea, tick, and heartworm prevention your pet is currently using. How often does your pet go the bathroom each day? What toys do you provide for your pet?, and what is his/her favorite? Is your dog possessive of any toys, foods, or objects? If yes, please explain your experience Has your dog ever bitten anyone? No Yes If yes, please explain the circumstance(s) How does your dog react to other dogs that approach in the yard or home?

4 If your dog has something in his/her mouth you did not want him/her to have, would he/she drop the object if asked, or will he/she let you take the object away? YES NO If no, explain your experience How does your dog react in public? Is your dog fearful of other dogs? No Yes Are you personally fearful of any type of dog(s)? Does your dog play off leash with other dogs? No Yes If yes, briefly explain your observations Are there any other animals in your household? No Yes If yes, please list Name/Age/Breed/Sex/ How does your dog get along with the others in the household? Are there any issues you feel we should be informed of, if so how serious do you consider the behavior to be? What is the main reason you have chosen daycare for your dog? TRAINING HISTORY What is your dog s training history? Circle what applies to you: No Training Trained Yourself Group Classes Private Lessons Puppy Kindergarten What commands does your dog know and how well is the response? (Always Usually Needs Work) Is your dog sensitive about parts of his/her body being touched? Ie: paws/toes/tail Do you wish to have your dog fed while here with us, and what feeding instructions do you follow? What is your dog s favorite treat?

5 WVMC DAYCARE WAIVER AND RELEASE OF LIABILITY I, owner of, understand and agree that I am responsible for any harm caused by my dog while attending day care. I agree that the information I provided is a true representation of my pets behavior, health, and medical status. I understand and recognize there are risks of illness, or injury when exposed to multiple dogs in a group setting. Such risks include, but not limited to: kennel cough, bites/and or scratches from rough play. I as the owner agree to be solely responsible for any/all acts of behavior for my pet while my pet attends WVMC s day care facility. Initials: If my pet should become ill and in need of medical attention, I authorize the veterinary staff of Wright Veterinary Medical Center, to perform medical, and/or surgical treatments necessary to preserve the life of my dog until I am contacted to make further medical decisions, and I will accept full financial responsibility for services performed. Initials: I understand that my pet may be placed in our boarding suites if necessary for a time out, or in extreme cases a muzzle may be necessary for staff, and pets safety. The owner will be notified immediately, should change in behavior become noticeable, and/or disruptive. Initials: I understand that pre-paid packages are non-refundable and expire 6 months from the date of purchase. Fees are due and payable at the end of each day by cash, check, or credit card. Discounts are applied for packages that are paid in advance. Initials: I agree that should my dog NOT be picked up by the end of the regular business day, (WITHOUT PROPER NOTIFICATION), WVMC will admit your pet into the boarding facility and be released the following day. Boarding fees will be applied and additional expenses will be paid by the owners at the time of discharge. Initials: I understand/agree that my pet is required to be spayed/neutered after the age of 6mos up to 8mos) to enroll in group daycare. Initials: I understand that if my pet has not attended daycare within a 6 month period, he/she will require a scheduled evaluation to be reintroduced to the current daycare attendees. Initials: **MEDIA CONSENT AND LIVE STREAM WEBCAMS** I understand that live stream webcams are available to be viewed by the open public on the website from the hours of 9:30am 5:30pm. Initials: I consent that any photos of my pet can be used for WVMC online media purposes. Initials: I have read and understand the regulations set by WVMC, and agree to the terms and conditions above. Owner s Signature: Initials: Date: WVMC Representative: Initials: Date: Contact our daycare team by phone or your inquiries to: infostaynplay@wrightvet.com Find us on Facebook and Instagram

6 The WVMC Day Care Team WHAT IS INVOLVED IN A DAYCARE EVALUATION FREQUENTLY ASKED QUESTIONS What is a daycare evaluation? We want to ensure the enjoyment and safety of all our pets in Daycare. An evaluation is given to assess your dog's social skills in a daycare group setting. The Daycare Evaluation is a one-day process to ensure that your pet has a personality suited for Daycare. The evaluation process is the first step to helping your pet have the social experience that will have him/her excited to come through our doors at every visit. What can I expect during this evaluation? We will review the application with you, and answer any questions you may have. You will leave your dog with us to get comfortable, and then we start to introduce your dog to some potential playmates. We will evaluate your dog's response to new environments, and behavior towards other dogs. We will make sure that your dog can be handled safely, and decide if your dog will be a good fit for our playgroup. Expect your dog to spend a minimum of 4 hours with us. Who performs the evaluations? The evaluations are performed by our trained daycare staff Can I just come in, or do I need an appointment? We do evaluations by appointment, so please schedule a day/time that works for your schedule We perform 2-3 evaluations per day only. This decreases the stress level for our regular daycare members. How much does it cost? This is a free assessment, and there is no charge to you. When will I know if my dog is a candidate? We will inform you after the evaluation. Please understand not all dogs are suited for group play, and we have other services that may be more suitable for your dog.