• Board & Train

    Service Contract
  • Client Information

  • Format: (000) 000-0000.
  • Do you consent to receive communication via text message?*
  • Emergency Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • May we share your training & behavior report with your veterinarian?*
  • Dog 1 Information

  • Gender
  • Is dog spayed/neutered?
  • Health Instructions

    *Please provide a copy of current veterinary records and vaccinations upon drop-off*
  • Feeding Instructions

  • Are other treats ok?*
  • Any allergies or dietary restrictions?*
  • Behavioral Instructions

  • Will a second dog be boarding?*
  • Dog 2 Information

  • Gender
  • Is dog spayed/neutered?
  • Health Instructions

    *Please provide a copy of current veterinary records and vaccinations upon drop-off*
  • Feeding Instructions

  • Are other treats ok?*
  • Any allergies or dietary restrictions?*
  • Behavioral Instructions

  • Which side of you do you want your dog(s) to walk on?
  • Description of Services & Payment

  • Form of Payment*
  • Please make your payment here

    www.successfultails.com/payment - select "Custom Amount"
  • Payment Options*
  • Liability Waiver & Policies

  • Emergency Policy: I authorize emergency medical care to be provided for my dog(s) by the above-named veterinarian, or an appropriate alternate to be determined by Successful Tails, LLC in the event that my regular veterinarian is not available or that closer care is required.  I will immediately reimburse Successful Tails, LLC for any charges related to vet care, including office fees, procedures, medications, surgeries, etc. Select one:*
  • Confirmation

    This contract is validated by the signatures below in total and as approval for future services without additional written authorization.

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: