Black Flag K9 Solutions Intake Form
1. Dog Information
a. Dog's Name:
*
First Name
Last Name
b. Breed:
*
c. Age:
*
d. Owner's Name:
*
First Name
Last Name
e. Owner's Contact:
*
f. Emergency Contact:
*
2. Vaccination Records
g. Please attach proof of current vaccinations, including current rabies, and Bordetella.
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3. Service being provided
Boarding
Date of drop off:
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of pick up:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Board and Train
Board and Train Duration
*
Please Select
3 Week Foundation Program
5 Week Advanced Off Leash Program
5 Week Behavior Modification Program
4. Food & Care Information
Food must be provided by the owner for the dog's stay.
Food/Brand:
Feeding Schedule:
Amount per Meal:
Allergies/Dietary Restrictions:
*
h. Special needs or medication:
*
5. Payment Terms
i. Boarding Fee: $70 a day (Daily rate is regardless of drop off or pick up time).
j. A deposit of 50% of the total amount for your dog's stay with us is required to secure your boarding or B&T dates. Please submit your deposit at least 5 days prior to boarding or B&T to confirm your reservation. The remaining balance for all board and train programs is due no later than 24 hours before the scheduled pickup date for the dog.
k. Accepted forms:
Accepted forms of payment
*
Please Select
Cash
Apple Pay
Zelle
Expectations & Liability
I, the owner, acknowledge that I am responsible for providing full disclosure of any behavioral or health issues my dog may have. I understand that Black Flag K9 Solutions is not liable for any injury, illness, or loss during boarding. I grant Black Flag K9 Solutions and its trainers or affiliated staff permission to seek emergency veterinary care if necessary, and I acknowledge that my dog may participate in training activities. I will notify Black Flag K9 Solutions immediately of any concerns, and I understand that cancellations may be subject to a fee.
Owner's Signature:
*
Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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Additional Notes
Open communication will ensure a safe and positive experience! Please use the space below to note any behavioral concerns, medical issues, or other important details that will help us care for your dog.
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