The Dog Wash & Grooming, INC National Road St. Clairsville, OH Phone: Web: Thedogwashandgrooming.com
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1 The Dog Wash & Grooming, INC National Road St. Clairsville, OH Phone: Web: Thedogwashandgrooming.com Owner Name: Street Address: City: State: Zip: Phone: Cell: Emergency Contact Information- Please tell us who you would prefer we contact in case of emergency Name: Phone: Name: Phone: If anyone other than the owner has permission to pick up your pet, please list their names below. Veterinarian Name: Phone: Street Address: City: State: Zip: Date of last Veterinarian visit: Pet s Name(1): Dog Cat Male Female Breed Color Markings Age Distinguishing physical characteristics Spayed Neutered Allergies Medications: (Please list the name of the medicine and what it is used to treat, along with dosage) Date of last DHLPP (Distemper, etc.) inoculation: Is your dog vaccinated for (Bordetella) Kennel Cough: Yes No Rabies expiration date:
2 Pet s Name(2): Dog Cat Male Female Breed Color Markings Age Distinguishing physical characteristics Spayed Neutered Allergies Medications: (Please list the name of the medicine and what it is used to treat, along with dosage) Date of last DHLPP (Distemper, etc.) inoculation: Is your dog vaccinated for (Bordetella) Kennel Cough: Yes No Rabies expiration date: Pet s Name(3): Dog Cat Male Female Breed Color Markings Age Distinguishing physical characteristics Spayed Neutered Allergies Medications: (Please list the name of the medicine and what it is used to treat, along with dosage) Date of last DHLPP (Distemper, etc.) inoculation: Is your dog vaccinated for (Bordetella) Kennel Cough: Yes No Rabies expiration date: Does your Pet(s) have any physical or medical problems which require special attention? Please describe in detail, including, surgeries, procedures, or injures:
3 Please complete the following information for each Pet so we can provide you and your Pet(s) the best boarding experience possible! Pet s Name(1): Has your Pet been boarded before? Is your Pet typically crated? Does your Pet experience anxiety/separation issues? Has your Pet ever escaped a fence (over or under)? Does Pet like to dig to escape? Is your Pet a runner or wanderer? Is your Pet a rescued Pet? If so, was your Pet previously abused? Not Sure If so, please explain: Is your Pet a destructive chewer? If so, is there anything you prefer your Pet to chew on to avoid injury? How does your Pet get along with other Pets? (Please explain) How does your Pet get along with people? (Please explain) Has your Pet ever bitten and/or attacked another animal or person? If so, please describe the circumstances surrounding the event: What else would you like us to know about your Pet? (for example, do they have a fear of thunderstorms, fireworks or loud noises?) Please list anything we should know in order to make their stay the most comfortable? Please list some of your Pet s favorite activities: (Playing ball, Frisbee, Tug of War, Water play, Brushing, Massaging, and don t forget the Belly Rubs!)
4 Please complete the following information for each Pet so we can provide you and your Pet(s) the best boarding experience possible! Pet s Name(2): Has your Pet been boarded before? Is your Pet typically crated? Does your Pet experience anxiety/separation issues? Has your Pet ever escaped a fence (over or under)? Does Pet like to dig to escape? Is your Pet a runner or wanderer? Is your Pet a rescued Pet? If so, was your Pet previously abused? Not Sure If so, please explain: Is your Pet a destructive chewer? If so, is there anything you prefer your Pet to chew on to avoid injury? How does your Pet get along with other Pets? (Please explain) How does your Pet get along with people? (Please explain) Has your Pet ever bitten and/or attacked another animal or person? If so, please describe the circumstances surrounding the event: What else would you like us to know about your Pet? (for example, do they have a fear of thunderstorms, fireworks or loud noises?) Please list anything we should know in order to make their stay the most comfortable? Please list some of your Pet s favorite activities: (Playing ball, Frisbee, Tug of War, Water play, Brushing, Massaging, and don t forget the Belly Rubs!)
5 Please complete the following information for each Pet so we can provide you and your Pet(s) the best boarding experience possible! Pet s Name(3): Has your Pet been boarded before? Is your Pet typically crated? Does your Pet experience anxiety/separation issues? Has your Pet ever escaped a fence (over or under)? Does Pet like to dig to escape? Is your Pet a runner or wanderer? Is your Pet a rescued Pet? If so, was your Pet previously abused? Not Sure If so, please explain: Is your Pet a destructive chewer? If so, is there anything you prefer your Pet to chew on to avoid injury? How does your Pet get along with other Pets? (Please explain) How does your Pet get along with people? (Please explain) Has your Pet ever bitten and/or attacked another animal or person? If so, please describe the circumstances surrounding the event: What else would you like us to know about your Pet? (for example, do they have a fear of thunderstorms, fireworks or loud noises?) Please list anything we should know in order to make their stay the most comfortable? Please list some of your Pet s favorite activities: (Playing ball, Frisbee, Tug of War, Water play, Brushing, Massaging, and don t forget the Belly Rubs!)
6 The Dog Wash & Grooming, INC National Rd West St. Clairsville, Oh Boarding Contract This is a contract between The Dog Wash & Boarding, Inc., known hereafter as DW&B, and the pet owner. DW&B agrees to exercise reasonable care and to keep kennel premises sanitary and properly enclosed for the safety and well-being of the pet(s) in their care. The pet(s) are to be fed, medicated, and cared for properly and to be housed in clean, safe quarters. All pets are boarded or otherwise handled or cared for by DW&B without liability on DW&B s part for loss or damage from disease, theft, fire, death, running away, injury or harm to persons, other animals, or property by said dog, or other unavoidable causes with due diligence and care having been exercised. Due to the social nature of a kennel, there are some inherent risks. These risks may include, but are not limited to: transfer of communicable diseases such as Canine Papilloma Virus (Puppy warts) and Kennel Cough. Injuries may include, but are not limited to: broken nails, sore feet, puncture wounds, abrasions and cuts. These injuries are generally benign and can typically be managed by our staff or at home. In some cases, veterinary care may be required. If your pet becomes ill or your pet s behavior endangers itself, other animals, or persons, DW&B, in it s sole discretion, may engage the services of a veterinarian. All attempts will be made to contact the Pet owner first: however, in the event of an extreme emergency, the well being of the Pet will be the priority. Medical attention and medication may become necessary and will be administered under the direction of a veterinarian. The undersigned Pet Owner gives the veterinarian complete authority to treat the Pet in whatever manner deemed necessary. Owner will be responsible for all veterinary charges upon release of the Pet. The Pet Owner also gives full authority for the treating veterinarian to discuss with DW&B any aspect of any illness or injury that DW&B has presented for treatment. We reserve the right to treat with over the counter medicine if DW&B staff find it necessary. Pet Owner specifically represents to DW&B that their Pet has not been exposed to rabies or distemper within a thirty (30) day period prior to boarding. DW&B requires proof of current Rabies, DHLP, and Bordetella (Kennel Cough) vaccinations. We require a Bordetella vaccination every twelve (12) months. The Bordetella vaccine is not 100% effective and it is recommended that dogs be given the vaccine at least two (2) weeks prior to Pet s arrival in order to increase efficacy. All Pets are checked for external parasites such as fleas and ticks upon arrival. If any are found, the Pet will be treated for the parasites and will be treated accordingly to DW&B policy, and Pet Owner will be responsible for those expenses. Pets are to be dropped off and picked up based on appointment time. If pet is not picked up at the appointed time a extended wait may be occur. In some circumstances an additional night stay may be necessary at owners expense. Cats are required to be up to date on Rabies and FVRCP. We are an interactive pet boarding facility. This means we require all dogs and cats to be spayed or neutered by 6 months of age. Any exceptions are with the authorization of management and only during off peak months. The DW&G is not responsible for any dog that may become pregnant white staying at the DW&G. It is understood by DW&B that all provisions of this Contract shall be binding upon both parties thereunto for this visit and all subsequent visits. By signing this Contract, Pet Owner certifies the accuracy of all information given about the Pet and accepts the terms of this Contract. The Owner specifically represents that he or she is the owner of the Pet. Owner authorizes DW&B to use pictures of their Pet taken while on the premises, participating in DW&B activities, and its website and in other promotional materials. This Contract contains the entire agreement between the parties. Signature of DW&B Representative Date Signature of Pet(s) Owner Date
7 Leash Laws All dogs must arrive and depart with a collar and leash Drop off and Pickups must be scheduled during DW&G office hours All vaccines must be up to date, and records must be given to DW&G upon check in Please label all items brought with your pet s belongings Please have food individually separated for meals Please have medication sheet filled out upon arrival Please leave all dog beds, blankets, toys, bowls, and other items at home. We will provide comfortable cots and blankets, as well as toys to play with. We are not liable for any items you bring, and cannot guarantee they come home clean or intact All pets must be on a flea prevention program prior to staying at the DW&G Limited office hours on Thanksgiving, December 24, December 25, December 31, January 1, and Easter Sunday All dogs over 50 pounds will have a day board trial to ensure safety of the dog, staff, and other boarders These rules are to keep your best friend safe and to allow them to have a dog-gone good time! Medication Sheet
8 *Make sure all medication is clearly labeled with pets First and Last name Pet s Name: 1) Name of Medication Doseage: How many times per day/time given: How is it admininstered: Prescribing Vet: 2) Name of Medication Doseage: How many times per day/time given: How is it admininstered: Prescribing Vet: 3) Name of Medication Doseage: How many times per day/time given: How is it admininstered: Prescribing Vet: 4) Name of Medication Doseage: How many times per day/time given: How is it admininstered: Prescribing Vet:
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Northwoods Animal Hospital 980 Northwoods Drive Cary, NC 27513 (919) 481-2987 (919) 481-3089 fax A. Melissa Hudson, DVM Kristin DeAngelo, DVM Howard Chappell, DVM BOARDING AGREEMENT FOR YEAR Owner / Agent
Playcare, Boarding, & Dog Walking Application
Playcare, Boarding, & Dog Walking Application Dog Owner Information Name Address City State Zip Work phone Home phone Cell Phone Email address How did you hear about us? Emergency Contact Information Name
YOU RELEASE CREATURE COMFORTS KENNELS AND ITS AGENTS FROM ANY LIABILITY FOR SUCH INJURY
Creature Comforts Kennels Boarding Agreement This Agreement and the Supplements referred to apply to all visits by your Pet to Creature Comforts Kennels ( CCK ). 1. Services. We agree to provide the specific
Scheduled Orientation is (date): At (time): Completed Paperwork New Client Information / Grateful Dogs Contract / Bath & Grooming Information
Thank you for your interest in Grateful Dogs! Grateful Dogs Clubhouse 202 Illinois Street El Segundo, CA 90245 Main: 310-364-0011 Fax: 310-364-0012 info@gratefuldogs.net Parent Orientation Information
Pooch Personality Profile
Pooch Personality Profile Complete a profile for each dog enrolled at Urban Tails. Complete responses assist us in providing high quality care for your dog. There are no right or wrong answers as all dogs
Guest Profile. Owner s Information. Pet s Information. Emergency Contact: General:
Guest Profile 1423 Wait Ave, Suite 340 B Wake Forest, NC 27587 Phone: (919) 556-8383 // Fax: (919) 453-1116 reception.pawsatplay@gmail.com www.pawsatplay.com Owner s Information Owner s Name: Co-owner
INN OF THE DOG. 865 S.W. Enterprise Way, Stuart, FL (772) Fax: (772) Innofthedog.com. Home Phone ( ) Cell Phone ( )
INN OF THE DOG 865 S.W. Enterprise Way, Stuart, FL 34997 (772) 288-1998 Fax: (772) 288-4338 Innofthedog.com 1 Owner Information Name Street Address City/State/Zip Home Phone ( ) Cell Phone ( ) E-mail address
PAW PRINTS PET RESORT GUEST APPLICATION FORM
Telephone: 250-597-DOGS Email: pawprintspetresort@gmail.com Web: www.pawprintspetresort.com PAW PRINTS PET RESORT GUEST APPLICATION FORM Date: Assessed by: Dog Information Dog s Name: Nicknames: Breed:
Daycare Application. Additional Owner s Name(s) authorized to drop off and pick up your dog
Fax (503) 990-6782 Daycare Application Dog s Name Date of Birth M F Breed _ Spayed/Neutered? Y N When? Weight Is your dog on a flea program? Y N If yes, product used Is your dog on a heartworm program?
All dogs must be at least 8 weeks of age or older. All dogs 7 months or older must be spayed or neutered.
GENERAL INFORMATION AND POLICIES Purpose: Sunny Acres Pet Resort Doggy Day Camp provides a safe, fun and stimulating social environment for dogs. To ensure the safety and health of your pet and our other
Sweet Pea Kennels New Client Documents. Please to or fax to Name (First and last) Address
` Sweet Pea Kennels New Client Documents Please email to records@sweetpeakennels.com or fax to 573-534-0133 Name (First and last) Address City State Zip Home Number Cell Email Emergency contact Emergency
New Client Questionnaire For multiple dog owners please complete one questionnaire for each dog.
The Crate Escape, Too 1364 Marshall Ave Williston, VT 05495 802-865-DOGS (3647) The Crate Escape, Inc. 1108 West Main Street Richmond, VT 05477 802-434-6411 www.crateescapevt.com New Client Questionnaire
Ranger s Pet Outpost and Retreat Service Agreement
Ranger s Pet Outpost and Retreat Service Agreement 1239 Minnesota Avenue, Winter Park, Florida 32789 - (407) 622-4884 Fax (407) 622-5197 rangers@rangerspetoutpost.com Primary Contact Secondary Contact
DAYCARE / BOARDING APPLICATION
Date: DAYCARE / BOARDING APPLICATION OWNER INFORMATION Address: City: Zip Code: Home phone: Cell: Work: E-mail Address: EMERGENCY CONTACT INFORMATION (someone t traveling with you) Relation: Home phone:
Owner s Name. Address. Primary Phone Alternate Phone. . Security Word (used for pick up verification) Other person authorized to pick up dog
Paws n Claws Playcare 1530 W 26 th St. Erie PA 16508 814-456-7297 fax 814-456-7299 Playcare Pet Profile Owner s Name Address City St Zip Code Primary Phone Alternate Phone Email Security Word (used for
Ranger s Pet Outpost and Retreat Service Agreement
Ranger s Pet Outpost and Retreat Service Agreement 1239 Minnesota Avenue, Winter Park, Florida 32789 - (407) 622-4884 Fax (407) 622-5197 rangers@rangerspetoutpost.com Primary Contact Name Secondary Contact
WHAT TO EXPECT Boarding > Day or Overnight
WHAT TO EXPECT Boarding > Day or Overnight Quail Corners Animal Hospital 1613 East Millbrook Road Raleigh, NC 27609 919.876.0739 Owner: Date: Pet: Thank you for scheduling a boarding reservation with us.
Pet Personality Profile
Pet Personality Profile Owner s Information Last Name: First Name: Phone: (cell) (home) (work) Email: Emergency Contact Name: Phone: Pet s Information Name: Breed: Color: Sex: M F Spayed/neutered? Yes
Metro Dog Day Care and Boarding Program Application
Metro Dog Day Care and Boarding Program Application Thank you for your interest in our programs for your dog. No one knows your dog better than you, which is why we appreciate you taking the time to fill
To get started with boarding or grooming please fill out the attached Boarding and Grooming Application.
Dear New Boarding and Grooming Customers, Thank you for choosing the Prison Pet Partnership to assist you with all of your boarding and grooming needs. We strive to provide the best care possible to your
OWNER SURRENDER FORM
P.O. Box 110987 Naples Florida 34108 Phone/Fax: 239-369-0415 info@grrswf.org www.grrswf.org OWNER SURRENDER FORM We understand that giving up your pet is a difficult decision, but we realize that in making
You are welcome to bring whatever you feel will make your pet s stay more comfortable for him/her, for example, bed/bedding/crates, toys and treats.
General information Please find a contract, terms of conditions and a 3 page questionnaire. I know this looks like a lot of forms, but this will ensure that your dog(s) are receiving the best care possible
Happy Hounds Doggie Day Care, LLC
Owner Information: Address: Happy Hounds Doggie Day Care, LLC Client Info Sheet Phone: Cell: Email: Additional Owner Information: Address: Phone: Cell: Email: Dog Info: Age: Breed: Sex: Weight: Additional