Dog Walking/Boarding Release Form
Client Information:
Client's Full Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Dog Information:
Dog's Name
Breed
Age
Dog's Birthday (Month/Day)
Medical Conditions or Special Instructions
Has your canine companion visited any dog parks?
Yes
No
If they have, how did they engage and socialize with other dogs?
Has your dog ever made an attempt to bite another dog or a person?
*
Yes
No
If the answer is yes, kindly provide further details.
Is your dog possessive when it comes to toys or food?
*
Yes
No
If so, please elaborate on this behavior.
Has your dog ever been involved in a scuffle with another dog?
*
Yes
No
If so, please provide additional information.
Are there any medical conditions or health concerns related to your dog that we should be aware of?
*
Does your dog have any specific triggers? i.e. Children, men, male/female dogs, bikers, moving automobiles?
*
Yes
No
If so, could you specify the type and how triggers are handled?
Emergency Contact:
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Veterinarian Information:
Veterinarian's Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Dog Walking Schedule:
Days of the Week
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Start Date
-
Month
-
Day
Year
Date
End Date
-
Month
-
Day
Year
Date
Start Time of Walks
Client's Signature
Date Signed
-
Month
-
Day
Year
Date
Ashley's Signature
Date Signed
-
Month
-
Day
Year
Date
Should be Empty: