Enrollment Form

Enrollment Form
You must also call our office and arrange an evaluation and possible daycare day for your dog before any reservations can be made!
Client Info
Name*

First NameLast Name
Email*
For report cards and important updates!
Phone Number*
Spouse/Partner

First NameLast Name
Email
Phone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pet Info
Dog #1 *
Name
Include a pic of your pup if you wish and we will use it for your dog’s profile! 🐶

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Breed*
Color(s)*
Weight*
Birthdate

MonthDayYear
Sex*

MaleFemale
Spay/Neutered*

YesNo (Must be altered by 9 months)
Dog #2 (if applicable)
Name
Include a pic of your pup if you wish and we will use it for your dog’s profile! 🐶

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Breed
Color(s)
Weight
Birthdate

MonthDayYear
Sex

MaleFemale
Spay/Neutered

YesNo (Must be altered by 9 months)
Dog #3 (if applicable)
Name
Include a pic of your pup if you wish and we will use it for your dog’s profile! 🐶

Cancelof
Breed
Color(s)
Weight
Birthdate

MonthDayYear
Sex

MaleFemale
Spay/Neutered

YesNo (Must be altered by 9 months)
Vet Info
Vet Practice *
Phone Number*
Vaccinations

Proof of vaccinations from your vet is needed. They can be sent from your vet OR if you have an invoice that shows the vaccination date for the required vaccines listed below that will work! You can bring it in with you, upload below, or email them to: MAIL@WIGGLYTAILS.COM
Health Requirements List:
1. Rabies
2. DHLPP (Distemper Multi)
3. Bordatella (Canine Cough)
4. Dog Flu (H3N2 or flu combo)
5. Negative Fecal Test (must be within the last 6 months)
6. Flea/Tick Medication
7. Internal Parasite Medication (Worms)
For Flea/Tick and Internal Parasites, those are usually administered by the owner so no "proof" is required but PLEASE make sure your dog is on these meds for his/her safety as well as the other dogs here at Wiggly Tails! :)
Vaccinations File Upload

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Has your dog shown aggression or bit another dog or person? If so, please explain in detail the circumstance.*
Does your dog have any medical issues or take any medication? If so, please explain and list the meds your dog is on.*
Any other information we should know about your dog?
How did you hear about us? If referral please let us know who. Thank you!
You must call our office and arrange an evaluation and possible daycare day for your dog before any reservations can be made!
Should be Empty:

Enrollment Form

Client Info

Pet Info

Vet Info

Vaccinations