Off-Leash Play Application

Off-Leash Play Application
We love dogs and want your dog to love coming to our off-leash playgroup. No one knows your dog better than you, so we’d appreciate you taking the time to fill out this application. We do understand that some questions do not apply due to your dog's age or if they have an unknown history. We ask that questions be filled out to the best of your knowledge. The more we know about the dogs in our care, the better our playgroups will be.
Owner's Name:*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Intro Questions
What type of socialization are you expecting for your dog? (please select all that apply)*

Engaging with other dogs (ex. running, wrestling, neck biting)Engaging with other dogs (ex. just being around other dogs, observing)Energy outletTrainingMental EnrichmentBuild confidence around people and/or dogsSeparation AnxietyOther
Why do you want your dog to participate in our off-leash playgroup?*
What are your expectations for your dog while in daycare?*
Dogs play with their mouths and paws so it is not unusual to have scrapes and scratches as a result of playing with other dogs. Even in supervised play a dog can have a bad moment and result in a puncture wound in another dog. How would you react if your dog received a minor injury of this type during play?*
Dog Information

Please submit one application for each dog who you would like to have in off-leash play

Rows	Dog's Name	Breed	Current Age	Spayed or Neutered

Where Did You Get Your Dog? (check all that apply)*

Newspaper AdAnimal ShelterBreederPet StoreAnimal Rescue GroupFound As A StrayOther
What knowledge do you have of your dog's past history?*
Why are you considering our off-leash play program for your dog? (check all that apply)*

Play with other dogsSo not home aloneExerciseRecommended by other pet professional (trainer, vet, etc)Other
Which of the following best describes your dog's level of socialization with other dogs?*

None - No knowledge of other dog interationMinimal - On leash encounters onlyModerate - Some off-leash play on occasion with visitor's/neighbor's/friend's dog(s)Extensive - Regular visits to dog social events, off-leash dog parks, dog daycare, etc.
Has your dog had any problems previously in an off-leash social environment?*

NoYes (check all that apply)Altercation or fight at a public dog parkAltercation or fight with a neighbor or friend's dogFearful reaction in a group of dogsDismissed from a prior dog daycare o social playgroup program (*complete next section)Other
*Only complete if you answered yes that your dog was dismissed from a prior program. What reason were you given as to why your dog was dismissed? Check each statement below that applies to the situation that resulted in your dog's dismissal.

My dog was injured, no medical treatment requiredMy dog was injured and required medical treatmentAnother dog was injured, no medical treatment requiredAnother dog was injured and required medical treatmentA person was injured, no medical treatment requiredA person was injured and required medical treatmentOther
Provide any other comments you want us to know about this situation.
Health History
Please describe your dog's flea/tick control and prevention program:*

Oral MedTopicalFlea/Tick CollarNoneOther
*Please note that flea/tick collars will be removed while your dog is in daycare. After applying topical preventative we ask that you wait 72 hours before bringing your dog into daycare.
Does Your dog have any allergies?*

NoYes
If yes please explain:
Does your dog have any physical disabilities?*

NoYes
Please explain disability and cause:
If answered yes, what restrictions need to be placed on your dog's activities or movements?

No jumpingNo runningNo hard playNo contact with other dogsOther
Does your dog have any medical conditions?*

NoYes
If yes, please explain. If medication is used to control the condition, please provide name and dosage.

Provide details of your dog's diet:*

Rows
Type (ex. raw, kibble, canned)
Brand (ex. Earthborn, Purina)
Primary Protein (ex. chicken, beef)
Feeding Schedule

On what type of surface does your dog generally go to the bathroom (ex. grass, pee pads)?*
Does your dog have any bathroom-related issues or concerns? If so please explain:*
Does your dog have any sensitive areas on their body? If yes please explain, if no just put no. *
Does your dog have favorite petting spots?*
How frequently is your dog walked outside? How long are your walks?*
Check the boxes below that best represents your dog's overall level of exercise routine*

Couch Potato - Spends days sleeping, occasional walks and/or playtime with humans or other dogs.Mild Exerciser - Short daily walks and/or regular playtime with human or other dogs.Moderate Exerciser - Long or multiple walks daily and/or regular playtime with human or other dogs.Athlete - Regular jogs/runs and/or regular participation in a dog sport activity such as agility, flyball, frisbee etc.
Household Information

Complete table with information on other pets in household:*

Rows	Breed	Age	Gender	Spayed or Neutered
1
2
3
4

Do any visitors bring their dog(s) to your house? If yes how do they get along?*
How does your dog react to a stranger coming into your home or yard?*
Does your dog ever bark or growl at anyone passing outside your home or yard? If yes please explain:*
Are there any type and/or breeds of dogs your dog seems to automatically fear or dislike? If yes please describe:*
How does your dog react to puppies?*
How does your dog react to another dog approaching him/her in a park or on a walk? Please answer for on leash and off of leash:*
Does your dog play with other Dogs?*

YesNo
If yes, which type?*

Male and femalesOnly malesOnly females
What kinds of games does your dog play with other dogs?*
What kinds of games does your dog play with people?*
Which commands does your dog know? (please check all that apply)*

SitStayComeDownHeelRolloverHigh FiveOther
How did your dog get his/her obedience training? (please check all that apply)*

Dog was sent to a board and train programAttended one group classAttended more than one level of group classes (beginner & intermediate, etc.)Private session in homeOther
Which of the following bet describes the use of obedience cues with your dog at home?*

Key part of daily communicationUsed when we go on walks or have people overUsed occasionally to better control behaviorRarely usedNot Applicable
What kind of a collar do you use to walk your dog?*

BuckleChain choke collarHarness - Leash Clips on backHarness - Front ClipHead Collar/HaltiProng CollarOther
Has your dog ever gotten away from someone when out for a walk? If yes please explain the circumstances:*
Where does your dog sleep?*

Inside the houseOutside the houseInside/Outside - varies
If your dog sleeps inside, where does he/she sleep?*

CrateOwner's bedDog cushion/bed on floorOther
Has your dog ever jumped up on someone? If yes what were the circumstances?*
How does your dog act when you get home at the end of the day?*
What does your dog do to show he/she is happy?*
What does your dog do to show he/she is upset?*
Is your dog allowed on the furniture at home?*

YesNo
Does your dog have any problems in any of the following areas: Mouthing, house-training, barking, digging, ignoring commands etc. If yes, please explain.*
Dog Behavior Information
Are there any particular types of people your dog seems to automatically fear or dislike?*
Has your dog ever growled at someone? If yes, what were the circumstances and how did you respond?*
Has your dog ever bitten a person? If yes, what were the circumstances and how did you respond? Please describe injuries if there were any:*
Has your dog ever bitten another animal? If yes, what were the circumstances and how did you respond? Please describe injuries if there were any:*
To the best of your knowledge, what does your dog do when you're not at home?*
Has your dog ever climbed/jumped a fence? If yes, what were the circumstances? How high was the fence?*
Has your dog ever escaped from your house or yard? If yes, please explain the circumstances:*
How would you describe the energy level of your dog?*

LowMediumHigh
Has your dog ever chased or tried to chase a small animal? If yes, what were the circumstances?*
Does your dog charge the fence when people/and or other animals walk by? If yes, do you take actions to prevent it?*
Is your dog frightened by thunderstorms? If yes, describe typical behavior and what specifically helps to relax your dog or calm his/her fear?*
Does your dog play with any toys? If yes, what kinds of toys does your dog like? *
Has your dog ever growled or snapped at a person who has taken food or toys away from him/her? If yes, what were the circumstances and how did you respond?*
Has your dog ever growled or snapped at another dog who has taken food or toys away from him/her? If yes, what were the circumstances and how did you respond?*
Have you ever notices your dog stopping and staring at another animal? If yes, what were the circumstances?*
Other comments or information about your dog that you feel might be helpful?
*By signing this you understand that you must provide physical proof of your dog's vaccinations; rabies (as required by Montana State Law) Distemper/Parvo, and Bordetella Intranasal. If your dog has had their Bordetella vaccination as an injectable or oral we require them to have the intranasal 6 months after the original date was given. Yearly dewormer is recommended but not required.

**Please bring physical proof of vaccinations on the day of your evaluation**
My dog is current on Rabies*

Agree
My dog is current on Distemper/Parvo*

Agree
My dog is current on Bordetella*

Agree
Signature*
Please select which days and times work the best for you, to bring your dog in for their evaluation. Our evaluations are only available Wednesday through Friday.

Please look in your emails/spam for our reply email. It is easier to get your dog set up for our evaluation that way. Also, we ask for at least 1-2 business days for our reply. We appreciate your patience!
Days of the week we offer for evaluations

WednesdayThursdayFriday
Here are our standard times for doing evaluations:

11:00 AM11:30 AM12:00 PM12:30 PM1:00 PM
Thank you for the time you spent completing the application form. We look forward to meeting you and your dog on evaluation day. Please contact us if you have any questions on the next steps of the evaluation process.
Should be Empty:

Off-Leash Play Application

Intro Questions

Dog Information

Health History

Household Information

Dog Behavior Information