The Dog Manor Registration Form
Please fill out the form entirely, one for each pet.
Your Name
*
First Name
Last Name
Your Phone Number
*
-
Area Code
Phone Number
Your Dogs Name
*
Your Email
*
example@example.com
Your Dogs Approximate Weight
*
In Lbs.
Your Dogs Breed
*
When was your dog born
*
Do you have pet insurance
*
What is their insurance number?
What is your pets MicroChip number?
Please nominate a local Emergency Contact. Please provide Name, Address and Number
*
Your Vets Details
In case of an emergency
Your Vets Name
*
Your Vets Contact Number
*
Your Vets Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you give us permission to contact them in case of an emergency? (we will always contact you regardless)
Yes
No
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Your Dogs Medical History and Information
If your dog has any medical conditions, has he/she been cleared by a Veterinarian?
*
Yes
No
Is your dog routinely vaccinated?
*
Has your pet had kennel cough vaccine? * Kindly note that It is a requirement that they do.
*
Which flea and tick preventative do you use?
*
If None, type None
How old was your dog when they were spayed?
*
If never, type Never
Does your dog have or have they had any of the following conditions?
*
Currently
Has Had
Prone To
Never Had
Seizures
Bloat
Pancreatitis
Cushings Disease
Lyme Disease
Stress Colitis
Diabetes
Heart Condition
Does your dog have any allergies or skin conditions?
*
If None, type None
Are there any places your dog does not like to be touched?
*
If None, type None
Please upload picture of your dogs vaccine record.
*
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Personality, Preferences and Past Experiences
Which 3 adjectives best describes your dogs personality?
*
Calm
Easy-Going
Worried
Inquisitive
Patient
Affectionate
Needy
Protective
Goofy
Playful
Bossy
Intense
Vocal
Which best describes your dogs energy level?
*
Low
Medium
High
Which categories of dogs does your dog interact consistently well with?
*
Males
Females
Small dogs
Medium dogs
Large dogs
Calm dogs
Rowdy dogs
Other
How would you describe your dog's play style?
*
King of the hill
Wrestle Mania
Likes to be chased
Likes to chase others
Shares toys/balls
Tug of war
Don't know
Other
How would you describe your dog's play style with PEOPLE?
*
Fetch
Tug of War
Wrestling
No Thanks
Other
Are there any types of PEOPLE that your dog dislikes? Please explain.
*
If Not, type None
Has your dog ever bitten anyone?
No
Yes
Other
Please tell us about any altercations/fights your dog has had when interacting with other dogs or people:
No Altercations or Fights
Altercations/ Fights But No Injuries
Dogs/People injured. Medical Treatment NOT Needed
Dogs/People injured. Medical Treatment Needed
At Home
In the Neighborhood
At a Friend's House
At the Vet, in a Store or Park
Off-Leash at a Dog Park
At Another Dog Daycare
Other
Are there any categories of dogs your dog automatically dislikes?
No
Yes
Other
How does your dog initially act in these situations:
Fearful/
Worried
Submissive/
Hesitant
Calm/
Relaxed
Excited/
Barking
Dominant/
Aggressive
Don't know
Meeting a new dog at the Vet, pet store or park
Greeting a puppy
Greeting a small group of dogs (2-3)
Greeting a large group of dogs (4+)
When another dog takes food. toys or a prized object
Watching a person with lawn equipment or a bicycle
How does your dog initially act in these situations:
*
Fearful/
Worried
Submissive/
Hesitant
Calm/
Relaxed
Excited/
Barking
Dominant/
Aggressive
Don't know
Greeting a stranger in Public
Interacting with Vet or Vet Tech
When a person reaches for your dog's collar or head
Being touched or approached with owner present
When hugged or lifted
When a person takes food, toys or prized objects
Interacting with other family dogs
Passing a calm dog on a leash
Passing an excited or barking dog on a leash
At a dog park or other social setting
How does your dog show that he/she is happy?
*
How does your dog show that he/she is upset?
*
Which obedience commands does your dog respond to consistently?
*
Come
Off/Don't jump
Sit Stay
Down Stay
Heel
Other
Does your dog have any problems in the following areas:
*
Jumping/Mounting other dogs
Housetraining
Barking
Chewing bedding
Destroying toys
Eating rocks/foreign objects
Has sensitive paws
Climbing fences
Ignoring commands
Other
How much experience has your dog had with other dogs?
*
Extensive
Moderate
Minimal
None
Has your dog ever stayed in a crate?
*
Yes
No
Is your dog safe in a crate?
*
Yes
No
Does your dog stay in a crate overnight?
Has your dog ever gotten away from you when out for a walk or escaped from the house/yard?
*
Yes
No
If Yes, how did you get your dog back?
Can your dog swim?
*
Yes, like a Pro
Yes, but not a fan
No
Unsure
If your dog has been swimming, please tell us which settings he/she is comfortable:
River
Lake or Pond
In the Ocean
Is your dog afraid of any of the following?
*
Thunderstorms
Fireworks
Most Loud Noises
Wind/Rain
None
Other
Walking and Feeding
Typical walking and Feeding routine
Is your dog lead trained?
*
How many times per week would you typically walk your dog?
*
How long might these walks be?
*
Please detail your dogs FEEDING guide. What they are fed, how much and often.
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The Dog Manor
Products and Services
Which of our programs or services are you most interested in for your dog?
*
Dog Daycare/Group Play
Puppy Training
Dog Walking
Social Skills Development
Dog Boarding
Other
How would you like to see your dog benefit from our Doggie Daycare/ Dog Boarding/ Dog Walking?
*
Have a great time playing with other dogs
Get lots of exercise
Learn group play manners
Become less fearful of other dogs
Take the edge off his/her boundless energy
Become less fearful of people
Not have to be home alone
Other
Has your dog ever attended another doggie daycare or dog walker?
*
No
Yes
Other
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Additional Details
Just a few more simple questions
Please provide other comments or information about your dog that you feel might be helpful:
Are there any Specific Boarding, Daycare or Walking Requirements that we should be aware of?
How did you hear about us?
*
Google
Facebook
Instagram
From my Vet
Word of Mouth/From a Friend
Other
If referred by a friend, please tell us who so we can thank them:
Thank you for registering with The Dog Manor
The next and final part of our registration form is regarding 'Consent'. It is important that you read, understand and consent to them as this forms the basis of all operations at The Dog Manor.
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Consent and Terms
Please do take your time and read carefully. This is the final stage of registration and the most important 'formal' aspect to our boarding, daycare, training and socialisation of dogs. Please tick each box that you FORMALLY CONSENT to.
In relation to the structured exercise of your dog; I FORMALLY CONSENT TO MY DOG
Being walked on a lead, on a designated route twice daily for 20 minutes.
Being walked with other dogs that are on or off leads.
Wearing a The Dog Manor tag whilst out walking.
Following the Daily Routine Card provided by The Dog Manor.
Being lead handled by any members of staff at The Dog Manor.
In relation to children and babies in the company of your dog; I FORMALLY CONSENT TO MY DOG
Playing indoors with children and babies in the company of supervising adult.
Playing outdoors with children and babies in the company of a supervising adult.
Boarding in the same home as children and babies.
Roaming freely off the lead amongst children and babies.
In addition
By consenting to points relating to 'children and babies' you hereby confirm that your dog is suitable to be around children and babies. That no harm will come to them.
In relation to structured environmental enrichment; I FORMALLY CONSENT TO MY DOG
Playing, exploring and learning within the rural ground of The Dog Manor; including but not exclusive too, bushes, trees, grass, gravel and wild grounds. In full knowledge of the surroundings such as the open fields and fence height.
Playing, exploring and learning, in, around or on agility equipment.
Playing, exploring and learning or taking part in activities in The Dog Manors private studio.
Relaxing, amongst the internal grounds (such as watching TV or having a cuddle) with The Dog Manor staff and their family. Including Children.
Playing, exploring and learning with various toys such as tennis balls or chew toys.
In relation to none structured exercise/ free play; I FORMALLY CONSENT TO MY DOG
Freely, whilst supervised, roaming the enclosed areas within The Dog Manor in full knowledge of the surroundings, open fields and height of all fencing.
Freely, whilst supervised, roaming the internal 'downstairs' of The Dog Manor.
Freely, whilst supervised, playing with other dogs either inside The Dog Manor or within their enclosed grounds.
Freely roam all grounds of The Dog Manor with prior knowledge and acceptance of the suitability of the fence height.
In relation to interactions with others: humans, dogs or other animals; I FORMALLY CONSENT TO MY DOG
Openly meeting multiple people within the structured setting of The Dog Manor.
Openly meeting multiple dogs within the structured setting of The Dog Manor.
Openly meeting other animals whilst within the structured setting of The Dog Manor.
Openly meeting other people, dogs and animals whilst out on specific walking routes.
In relation to feeding; I FORMALLY CONSENT TO MY DOG
Being fed by a member of staff at The Dog Manor. As per your strict instructions
Being fed alone, separated from other dogs, with their own bowl for period of 30 minutes.
Only eating the meals provided by me (the owner).
Only eating treats provided by me (the owner), unless expressly otherwise permitted in writing.
If sleeping as a family (multiple boarding dogs from the same home); I CONSENT TO MY DOG eating in the same room as MY OTHER DOG.
In relation to sleeping; I FORMALLY CONSENT TO MY DOG
Sleeping separately from other dogs, within their own room.
Sleeping in a crate provided by myself (the owner)
Sleeping through the night 21:00 - 07:00, unless otherwise advised in writing or specific dog needs are required (such as young puppies or dogs with conditions).
If sleeping as a family (multiple boarding dogs from the same home); I CONSENT TO MY DOG sleeping in the same room as MY OTHER DOG.
In relation to welfare; I FORMALLY CONSENT TO MY DOG
Having a daily welfare check by a suitably qualified members of staff at The Dog Manor.
Being monitored daily and appropriate records or this kept.
Being given any medication provided by me (the owner) as per my exact instructions.
In relation to emergencies of the home or staff of The Dog Manor; I FORMALLY CONSENT TO MY DOG
Being placed under the immediate care of another reputable dog boarder should a licence revocation be made.
Registration and booking form being made available to our emergency key holders and handlers.
In relation to dog welfare emergencies; I FORMALLY CONSENT TO MY DOG
Being given emergency vet treatment. Preferably by my (the owners) own Vet but in the instance of their unavailability: The Dog Manors own Vet.
Key Welfare Terms
By ticking the points below relating to 'welfares' you hereby accept the points as written.
In relation to dog welfare ; I FORMALLY AGREE THAT
*
Should an accident occur and Vet support become necessary; I agree to take responsibility for any vet bills in full. Being given emergency vet treatment. Preferably by my (the owners) own Vet but in the instance of their unavailability: The Dog Manors own Vet.
Should your pet become unwell and Vet support becomenecessary; I agree to take responsibility for any vet bills in full.
Finally upload a picture of your dog that we can use for our emergency procedure file.
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