Golden Paw Tregeagle Boarding Questionnaire

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Your Name: Address: Mobile: Email: Drop off date: / / Pick up date: / / Time: Time: (our drop offs and pick ups are by appointment between 8-10 or 2.30-4.30) Person to contact in case of an emergency: Is your dog actively social? Dog s Breed: M/F? Desexed? Age: D/O/B(If Known) / / Is your dog on any flea and tick prevention? YES / NO Brand: If required please administer flea and tick prevention at least one week prior to their stay Please list any current health problems or concerns you may have with your dog:

Is your pet on any medication or supplements? If so please list medications and instructions for care: Who is your regular vet? What do you normally feed your dog? How many times a day do you feed your dog? Are there any foods or treats your dog is NOT allowed to have? We offer the dogs raw meat bones, please let us know if your dog is ok to eat bones YES / NO If two or more dogs are staying together (from the same family) can they be given bones together or do they need to be separated? Guests are given plenty of outdoor time and exercise both on and off lead. Does your dog need exercise or activity limited due to any physical health concerns? YES / NO We offer swimming in our dog pool as a summer activity for our guests. Is your dog ok to participate in this activity? YES / NO Has you dog ever bitten another dog or human? PLEASE BE HONEST!!! YES/ NO Are there any other health concerns ie: injuries, muscle soreness, stomach upsets, loose bowel, anxiety, cuts, etc that your dog may have.. or any other behavioural issues we need to know about ie: jumping, biting, digging, aggression towards other dogs - size, breed, sex etc., pulling on lead when walking, fence jumping, excessive barking, anxiety etc.

Golden Paw Tregeagle My dog is: Good with other dogs Spends most of the time inside with the family Is a digger and will dig out of a fenced area Is a jumper and will jump out of a fenced area Walks well on a leash Can swim and likes to go in the water Can be nippy Is afraid of thunder Is afraid of loud noises Is a chewer and can destroy things Is ok to be bathed if required

We offer a range of additional services to make your dog s stay even more enjoyable. Please have a look at our Spa Services menu for a more detailed description of our treatments: Welcome treatment $25 YES / NO number: Essential Oil Massage $40 YES / NO number: Hydrotherapy $35 YES / NO number: Laser Phototherapy $20 YES / NO number: Nail Clip $15 YES / NO number: Dog wash $15 - $30 YES / NO number: Beach Trip $55 YES / NO number: Reiki $60 YES / NO number: Animal Communication $80 YES / NO number: Combined - Reiki and Animal Communication $100 YES / NO number: One-on-One walk or Run - please note that this would be in addition to our regular daily exercise $25 YES / NO number: Grooming from $55 Please note all grooms are off site at Woof Whistles with free pick up and drop back on the same day Please advise if a groom is required prior to stay so we can arrange their booking and please complete a grooming form AFTER VISIT CARE - We encourage a healthy lifestyle at the golden paw, would you like to continue with our healthy cuisine? Take home meals are available price and details available on request

TERMS & CONDITIONS I understand that while every care will be given to my dog, they are boarded entirely at my own risk. I acknowledge that it is the policy of The Golden Paw to allow dogs to exercise outside their kennels and within common exercise areas along with other dogs of compatible natures. I consent to my dog being exercised and indemnify The Golden Paw against any suit or claim arising from any loss or injury to my dog (s) whilst being so exercised. Should your dog require veterinary treatment during their stay at The Golden Paw, all costs involved with the veterinary treatment including transportation will be charged to your account. In the event of a medical emergency we will take your dog to Alstonville Vet or the closest on call clinic open after hours. For minor health concerns we will treat with acupuncture, essential oil therapy, herbs and laser therapy. Do you consent to treatment with alternative therapies at our discretion if required (there will be no additional charges for minor health concerns)? YES / NO Due to the high incidence of paralysis ticks in this area we highly recommend the use of a tick preventative. Please be aware that some collars need to be worn for 1-2 weeks before they provide adequate protection. The Golden Paw will not be held responsible for any injury, sickness, or death that may occur to any dog while in the care or being transported by The Golden Paw or its employees. Vaccinations - if required please vaccinate at least 14 days prior to stay Owner s Name: Owner s Signature: Date: / /