Scrumps Boarding Enquiry Form
Scrumps is committed to safeguarding the privacy of its clients in strict compliance with the New Zealand Privacy Act. All Information gathered by Scrumps is kept on a secure server.
Check-in date:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Check-out date:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Check-in Time:
Approximate
Check-out Time:
Approximate
Number of Guests?
*
Please Select
1
2
3
If more than 3 guests are required please Contact Scrumps directly
Dog Details:
Dog's Name:
*
Dogs Age:
*
Dog Breed:
*
Just checking sizes! :)
Dog's current Vet
*
Is your Dog Microchipped?
Yes
No
Dogs Microchip #
If available.
Is your dog Spayed/Neutered?
*
Yes
No
Please let us know why they are not desexed in the provided text box.
This is just so we have a record for your dogs safety.
Is your dog Vaccinated?
*
Yes
No
Please advise when they will be vaccinated in the provided text box.
All dogs must have the NZ Standard Vaccines to attend Scrumps
Take a photo of your dogs vaccination record and upload here (If available)
Does your Dog have an existing medical condition?
*
Yes
No
Briefly explain what those medical conditions are.
Does your Dog have any known allergies?
*
Yes
No
Briefly explain what those allergies are
Is your Dog okay with stock?
*
Yes
No
Other
Is your Dog okay with Cats?
*
Yes
No
Other
Is there anything you would like to let us know about your Dog?
Any special behaviours? Anything they aren't allowed to play with? Shy with other dogs? Nervous around children?
Feeding Instructions:
Is your dog currently on any medications?
Yes
No
Please explain how often and how they receive their medications:
Where does your dog normally sleep?
2nd Dog Details:
Dog's Name:
*
Dogs Age:
*
Dog Breed:
*
Just checking sizes! :)
Dog's current Vet
*
Is your Dog Microchipped?
Yes
No
Dogs Microchip #
If available.
Is your dog Spayed/Neutered?
*
Yes
No
Please let us know why they are not desexed in the provided text box.
This is just so we have a record for your dogs safety.
Is your dog Vaccinated?
*
Yes
No
Please advise when they will be vaccinated in the provided text box.
All dogs must have the NZ Standard Vaccines to attend Scrumps
Does your Dog have an existing medical condition?
*
Yes
No
Briefly explain what those medical conditions are.
Does your Dog have any known allergies?
*
Yes
No
Briefly explain what those allergies are
Is your Dog okay with stock?
*
Yes
No
Other
Is your Dog okay with Cats?
*
Yes
No
Other
Is there anything you would like to let us know about your Dog?
Any special behaviours? Anything they aren't allowed to play with? Shy with other dogs?
Feeding Instructions:
Is your dog currently on any medications?
Yes
No
Please explain how often and how they receive their medications:
Boarding Preference:
3rd Dog Details:
Dog's Name:
*
Dogs Age:
*
Dog Breed:
*
Just checking sizes! :)
Dog's current Vet
*
Is your Dog Microchipped?
Yes
No
Dogs Microchip #
If available.
Is your dog Spayed/Neutered?
*
Yes
No
Please let us know why they are not desexed in the provided text box.
This is just so we have a record for your dogs safety.
Is your dog Vaccinated?
*
Yes
No
Please advise when they will be vaccinated in the provided text box.
All dogs must have the NZ Standard Vaccines to attend Scrumps
Does your Dog have an existing medical condition?
*
Yes
No
Briefly explain what those medical conditions are.
Does your Dog have any known allergies?
*
Yes
No
Briefly explain what those allergies are
Is your Dog okay with stock?
*
Yes
No
Other
Is your Dog okay with Cats?
*
Yes
No
Other
Is there anything you would like to let us know about your Dog?
Any special behaviours? Anything they aren't allowed to play with? Shy with other dogs?
Feeding Instructions:
Is your dog currently on any medications?
Yes
No
Please explain how often and how they receive their medications:
Boarding Preference:
Owner Details:
Owner's name:
*
First Name
Last Name
Phone Number
*
E-mail Address:
*
Emergency Contact :
*
First Name
Last Name
Phone Number:
*
Are you happy for Scrumps to use photos of your Dog for Social Media Purposes?
*
Yes
No
In the event of injury, do you consent to Scrumps seeking Veterinary assistance for your dog if necessary?
*
Yes
No
Questions or Comments?
Send
Should be Empty: