Located in East Peoria, Illinois
Inactive - Dog Daycare Enrollment Form
Your dog is giving you two paws up and a woof-woof for doing this
IMPORTANT: Please read before completing enrollment form.
We do require weekly attendance (or more) year-round. We are not a "drop-in" daycare. Our program's success is based on regular attendance by all it's members.
Pet Parent #1
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Employer
Pet Parent #2
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Employer
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If different last names, which last name would you like for us to use
If multiple parents, please note first contact
Who else is authorized to drop off/pick up your dog?
Emergency Non-Owner contact (not your Veterinarian). Who should we call if we cannot reach you while your dog is with us?
*
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Play All Day will always use reasonable efforts to contact Pet Parents in the case of illness or injury. If Pet Parents cannot be reached, Play All Day is authorized to make appropriate decisions regarding Veterinary care.
Name of Dog
*
Breed/Breed Type
*
Color
*
Sex
*
Female
Male
Spayed Female
Neutered Male
We do accept intact male & female dogs. If your dog is not spayed/neutered, do you have plans for this in the future?
*
Dog's weight currently. And if puppy, what is expected adult weight?
*
Dog's Age
*
Date of Birth
*
Date of Adoption
*
Veterinarian (name of Vet & Clinic)
*
Veterinarian Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How Did You Hear About Play All Day
*
Referral from existing client
Local Business Referral (Veterinarian or Groomer)
Social Media
Internet Search for Dog Daycare
Other
We love to reward referrals. If you were referred from one of our existing clients, please let us know their name. We will give them one free day of daycare for the referral.
Today's Date
*
-
Month
-
Day
Year
Date
Where did you get your dog (breeder, shelter, friend, etc)?
*
What knowledge do you have of your dog's past history?
*
Why are you considering Play All Day for your dog (check all that apply)?
*
Socialization
Exercise
Play with other dogs
Exhibits signs of separation anxiety
Recommended by another pet professional
Long hours at home alone
Please add any additional comments on why you are seeking daycare at this time.
*
How would you describe your dog's energy level?
*
Low
Medium
High
Bouncing off the walls
Please describe in more detail, your dog's socialization with other dogs. What dogs do they see/play with? On-leash/off-leash? Is your dog excited, scared, happy, over -excited during these interactions? What role do they play in these interactions (instigate play, roll over on back, chase, invite chase, wrestle, etc)?
*
Has your dog had problems in an off-leash social environment?
*
No
Yes
If yes, what were the issues? Were there injuries?
*
Has your dog attended Dog Daycare in the past?
*
Yes
No
If yes, please explain your experience and what feedback you received from the daycare regarding your dog's playstyle and behavior.
Has your dog been dismissed from dog daycare in the past
*
No
Yes
If yes, please explain further.
What are your dog's favorite games with you? With other dogs?
*
Has your dog ever shared his/her food or toys with other animals?
*
No
Yes
If yes, please describe the interaction.
Please describe your dog's flea/tick control and prevention program
*
Does your dog have any allergies?
*
No
Yes
Does your dog have any physical limitations?
*
No
Yes
If yes, please describe
Does your dog have any medical conditions
*
No
Yes
If yes, please describe.
Please describe your dog's diet and feeding schedule.
*
How does your dog react to bathing and nail trims?
*
Does your dog have any sensitive areas on his/her body?
*
No
Yes
If yes, please describe
Please describe your dog's current exercise opportunities (walks, runs, distance, frequency, etc).
*
Please list any other household pets in your home. Include breed, age, and how this dog gets along/interacts with them.
*
How does your dog react to a stranger coming into your home or yard?
*
How does your dog react to another dog approaching you on walks?
*
How did your dog get his/her obedience training? Please check all that apply.
*
Group Training Class
Board & Train
Private sessions in home
Trained by Pet Parent(s)
Which commands does your dog know? Please check all that apply.
*
Sit
Down
Stay
Come when called
Loose leash walking
Tricks
What type of collar do you use to walk your dog
*
Plain flat buckle collar
Harness - back clip
Harness - front clip
Head collar
Metal choke collar
Metal pinch collar
Electronic collar
Please add any comments related to your dog's obedience training that you feel are important.
Has your dog ever escaped a fence enclosure?
*
No
Yes
If yes, please explain.
Where does your dog sleep?
*
Inside the house
Outside the house
In which room does the dog sleep?
*
The dog sleeps
*
in a crate
on a dog bed
on the floor
in the human bed
Is your dog allowed on the furniture at home?
*
No
Yes
Is your dog comfortable in a crate?
*
No
Yes
If no, please explain.
Is your dog afraid during thunderstorm or other loud noises
*
No
Yes
If Yes, please explain further.
What does your dog do when nervous or upset?
*
What does your dog do during the day when you are away from home?
*
Does your dog jump up on people to greet?
*
No
Yes
Does your dog have any problems in any of the following areas?
*
Mouthing
Housetraining
Barking
Digging
Ignoring commands
Describe further
Has your dog ever growled at a person?
*
No
Yes
If yes, what were the circumstances and what did you do?
Has your dog ever bitten a person?
*
No
Yes
If yes, what were the circumstances and what did you do?
Has your dog ever growled at another dog?
*
No
Yes
If yes, what were the circumstances and what did you do?
Has your dog ever bitten another dog?
*
No
Yes
If yes, what were the circumstances and what did you do?
Other comments or information about your dog that you feel might be helpful for us to know?
*
Signature
Thank you for taking the time to fill this form out completely. The information helps us to shape your dog's experience and sets the stage for success. We do realize the form is long and we appreciate your efforts.
You should hear from us within 24 hours of submitting this form. We will contact you by email to set up the next steps in getting your dog started in daycare. Be sure to check your email and if you do not see us, check your Spam. If nothing there, please do follow up with us.
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Status
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Non-Client
New
Current
Returning
Left
Dismissed
Reason for non-clients (if applicable)
Please Select
Reached out twice with no response
Dog didn't pass assessment
No call no show on first day - no response
Decided on another daycare
Didn't like the membership model
Couldn't come every week
Check-in times don't work
Check-out times don't work
Didn't like nap time
Other
Returning Date
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Month
-
Day
Year
Date
Returning Reason
Please Select
Snow Birds
Surgery
Injury
Other
Returning Reason "Other" Details
Leaving Date
Please Select
Start Date
-
Month
-
Day
Year
Date
End Date
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Month
-
Day
Year
Date
Exit Reason
Please Select
Dismissed
Moved
Financial Reasons
Dog passed away
Going to different daycare
They had issues with us
Other
Issues with us (if applicable)
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X
Y
Z
Day1
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Group1
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Day Group Combo 1
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Day2
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Group2
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Day Group Combo 2
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Day3
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Group3
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Day Group Combo 3
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Notes
Should be Empty: