Rainbow Policy

Owner's Name*

Phone Number*

Please enter a valid phone number.

Email*

Owner's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Pet's Name*

DOB*

SEX*

Breed*

Overall Health*

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House of Dog Retreat & Spa LLC's policy is to have on file a Rainbow Protocol for senior dogs (10 years or older) or dogs with a medical/physical condition(s) that could be life threatening. This is a precautionary measure to assist us in following your wishes in the unlikely event your pet passes away while in our care. Any dog over the age of 10 or has a medical/physical life- threatening condition cannot board with House of Dog Retreat & Spa LLC unless there is a completed/signed House of Dog Retreat & Spa LLC Rainbow Protocol on file.

Please check of your wishes below:

I want my emergency contact , phone # to be called and to pick up my pet if they pass before I return.

(My emergency contact will assume the responsibility to pick up your pet and follow thru on your arrangements. If your emergency contact is unreachable, you understand that House of Dog Retreat & Spa LLC will transport your pet to Type a label Type a label Hospital on your behalf and the expenses will added to your bill.

I authorize House of Dog Retreat & Spa LLC to transport my pet to Type a label for cremation and wish to have my dog’s ashes returned to me. yes no

I authorize House of Dog Retreat & Spa LLC to transport my pet to _________________________________for cremation and do NO Type a label T wish to have my ashes returned. yes no
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By signing below, you understand House of Dog Retreat & Spa's Rainbow Protocol and Agreement. You give House of Dog Retreat & Spa permission to follow your directions as stated above. In addition, you attest that you have read and understand the Liability Release Statements and both are in agreement and will comply with them:

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Date

HOUSE OF DOG