New Membership Application Form

Pet Owner Full Name

First NameLast Name

Pet Owner Email

example@example.com

Pet Owner Home Phone (xxx) xxx-xxxx

Please enter a valid phone number.Format: (000) 000-0000.

Pet Owner Cell Phone (xxx) xxx-xxxx

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Service Interested In

Preferred Arrival Date for Boarding

Date

Preferred Departure Date for Boarding

Date

Emergency Contact(s): In the event of an emergency, who should we contact first?

Authorized Person(s) to Pick-Up My Pet

How did you hear about us? (Check all that apply)

Pet's Name

Breed

Age/Birthday

Sex

Spayed or Neutered

Colors/Markings

Special Needs or Allergies

Check all commands that your dog knows below:

Can your dog do any other commands that are not listed? Please list below.

Vet's Name and Phone Number

Professional Obedience Education

Has your pet ever boarded before?

If yes, please describe your pet's boarding experience:

Has your pet ever been to daycare?

If yes, please describe your pet's daycare experience:

Check all attributes that apply to your pet:

Check all personalities that apply to your pet:

Check all behaviors that apply to your pet:

Check all that your pet likes:

Check all that your pet dislikes:

Does your pet engage in any unusual or repetitive behaviors?

If yes, explain unusual or repetitive behaviors below:

Has your pet ever bitten a person?

If yes, please explain the situation:

Has your pet ever bitten another pet?

If yes, has your pet bitten another pet, please explain:

Has your pet ever growled at someone?

If yes, has your pet ever growled at someone, please explain:

Has your pet ever growled or snapped at anyone who has taken their food or toys away from him/her?

If yes, please explain:

Are there any particular types of people your pet seems to fear or dislike?

If yes, please explain:

Is your pet an escape artist?

If yes, please explain:

Is your pet frightened of thunderstorms or loud noises?

If yes, please describe what happens and how you soothe your pet's fear:

Describe your pet's activity level:

Where are your pet's favorite petting spots?

What level of socialization best describes your pet's routine?

Are there types/breeds of dogs your pet seems to automatically fear or dislike? Please explain:

How does your pet react to another pet approaching them in the park or on a walk?

Does your dog play with other pets?

If yes, please describe size, breed and temperament of the other pets:

What games does your pet like to play with people?

What kind of games does your pet like to play with other pets?

Where does your dog sleep at night?

Does your pet have allergies?

If yes, please provide what they are allergic to in detail below:

Does your pet have any bathroom related issues or concerns?

If yes, please explain:

Does your pet have any physical disabilities?

If yes, please describe disability or physical restrictions:

Does your pet have any pre-existing medical conditions?

If yes, advise of any medication used to control the condition (please include name and dosage amount in detail):

My pet will require snuggles and hugs to administer medications:

If your pet requires medication, provide type, reason, frequency and dosage in detail below:

Please provide diet information below (brand, type, amount, frequency):

Large Dogs Only – Does your pet need a raised feeder?

My dog can have treats?

Vaccination Guidelines: Please review our vaccination guidelines. For questions or concerns please contact us.

Evaluation Fee Required for Evaluation Appointment - Paying this does not mean you are enrolled as a member. You are paying for your pet to be evaluated.

Evaluation Fee

$40.00

Product Name

Free Quantity

Total

Credit Card