Doggy Daycare Enrollment Application

Doggy Daycare Enrollment Application

Daycare Requirements: All dogs must be current on Rabies, Bordetella, DHLPP, Canine Influenza, Negative Fecal within the past 6 months, and on flea/tick prevention. Dogs over 7 months old must be spayed or neutered.
Owner Information
Owner's Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact (MUST be someone other than Owner)*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Who is allowed to pick up your dog from daycare? List Name and Phone Number*
ID is required for non owner pick ups. Only person(s) listed on your account are allowed to pick up.
Pet Information
Pet's Name*
Birthdate*

MonthDayYear
Date
Sex (Dogs over 7 months must be spayed or neutered to attend daycare)*

Male, NeuteredMale, Not NeuteredFemale, SpayedFemale, Not Spayed
Breed(s)*
Color*
Weight (approx.)*
Recent Pet Photo

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How long have you had your dog?*
Where did you get your dog?*
What is your goal for doggy daycare? Check all that apply*

ExerciseNeeds SocializingLikes to be around other dogsDon't want them to be alone for long periodsMy schedule is very busyHas separation or isolation anxiety needs companyOther
Name of Veterinary Clinic *
Clinic's Number*
Please enter a valid phone number.Format: (000) 000-0000.
Vaccination Records

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Does your dog have any chronic health conditions or recent surgeries?*

YesNoUnknown
If yes, how do these affect their daily life and do they have any limitations?
Does your dog take daily medication?*

YesNo
If yes, please specify
Does your dog have any allergies or dietary restrictions?*

YesNoUnknown
If yes, please specify
Can we give your dog treats?*

YesNoTreats from home only
Does your dog have any food or toy related behavioral issues (e.g., growling, biting) If so, please give detail on the situation(s).*
*Dogs that show resource guarding tendencies may not be eligible for daycare
Is your dog crate trained?*

YesNoOnly crated once in a while
Have you noticed that your dog is afraid of any types of dogs (size, breed, color)? Explain.*
Is your dog sensitive about any parts of his/her body? (i.e., tail touched, paws touched, head, etc,)*
Has your dog ever shown aggression towards people or other dogs? If yes, please give as much detail as possible. *
Does your dog show any fear or anxieties towards the following? Check all that apply*

No Anxiety or FearPeopleThunderstormsLoud NoisesSudden MovementsOther
If so, how do they typically react and how do you comfort them?
How does your dog react to new environments and unfamiliar people? *
Does your dog have any favorite toys or activities? *
How much exercise does your dog usually get? Do they have a preferred type of exercise or game?*
What level of training has your dog received (basic obedience, advanced training)? How consistent is their response to commands when off leash?*
Is your dog easily aroused/excitable?*

YesNo
Does your dog jump on people?*

YesNo
Does your dog climb fences?*

YesNoUnknown
Which best describes your dog? Check all that apply.*

High energyWary of new human friendsWary of new dog friendsKeeps to him/herselfCouch potatoWants to be friends with everyoneAlways InvestigatingParticular about toys/treats/bedsLoves napsLoves to playHappy go luckyLoves to "talk"Anxious/NervousEnergizer bunnyTreat motivatedPrefers the company of human friendsOther
How many days per week do you think you'll use daycare?*

1-2 Days3-4 Days5 DaysOnce every couple weeksOnly when BoardingOther
Scheduling preferences for daycare*

MondayTuesdayWednesdayThursdayFridayDays would vary each weekOther
How long will you dog attend daycare each day?*

Half Days (Under 6 hours)Full Days (Over 6 hours)Times will vary
Has your dog ever attended a dog daycare?*

YesNo
If your dog has been to daycare currently or before, why are you leaving or why did you stop?
Have they ever been dismissed from a daycare? If yes, please explain
Has your dog played off-leash besides family dogs?*

Yes, all the timeYes, a few timesNo
Does your dog have any doggy friends?*

No1-22-44+Only friends with other dogs in the same home
Describe how your dog plays with their friends. Check all that apply*

Rough & TumblesMouthyGentleLikes to jump on other dogsFloppy, falls over and helps other dogs play and be comfortablePlay bowsOther
How did you find us?*

FacebookGoogleReferralOther
Did someone refer you? Please tell us who so we can thank them.
Would you like us to contact you to schedule your dog's evaluation?*

Yes, Please CallYes, Please EmailNo, Just LookingNo, I Will ContactOther
Are you interested in learning more about our other services? Check all that apply*

BoardingTrainingGroomingOther
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Doggy Daycare Enrollment Application

Owner Information

Pet Information