The Bearded Dog – Boarding Intake
Please complete this form so we can prepare a safe, comfortable stay for your pet.
Owner & Booking Information
Owner full name
*
First Name
Middle Name
Last Name
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email address
*
example@example.com
Street address
*
City
*
State
*
ZIP code
*
Requested boarding drop-off date/time
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Requested pickup date/time
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Preferred contact method
*
Phone
Email
Text message
Are your boarding dates flexible?
*
Yes
No
If yes, please share any flexibility notes
Emergency & Veterinary Contacts
Emergency Contact Full Name
*
First Name
Middle Name
Last Name
Relationship to Owner/Pet
*
Please Select
Spouse
Parent
Sibling
Friend
Neighbor
Relative
Other
Primary Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Regular Veterinarian Name
*
Clinic Name
*
Clinic Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Clinic Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Preferred Emergency Veterinary Hospital (if any)
Pet Information
Pet Name
*
Species
*
Please Select
Dog
Cat
Bird
Rabbit
Other
Breed
Sex
*
Male
Female
Unknown
Spayed/Neutered
*
Yes
No
Unknown
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
Color / Markings
Weight (lbs)
Health Requirements
Rabies vaccination current?
*
Yes
No
Rabies vaccination expiration date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Other vaccinations current?
*
Yes
No
Other vaccination expiration date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Upload vaccination record(s)
*
Upload a File
Drag and drop files here
Choose a file
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Does your pet have any allergies?
Yes
No
Allergy details (include triggers and reactions)
Does your pet have any medical conditions?
Yes
No
Medical condition details
Does your pet take any medications that we should administer?
*
Yes
No
Medication details (name, exact dose, timing, and instructions)
*
Does your pet have any mobility or sensory limitations?
Yes
No
Mobility or sensory limitation details
Has your pet had any recent illness or exposure to illness?
Yes
No
Recent illness or exposure details
Is your pet on parasite prevention?
Yes
No
Parasite prevention details (product and last administered date)
Authorize staff to administer the listed medications?
*
Yes
No
Authorization signature
*
Feeding & Daily Routine
Food brand or type
*
Amount per meal
*
Feeding time - Morning
Hour Minutes
AM
PM
AM/PM Option
Feeding time - Evening
Hour Minutes
AM
PM
AM/PM Option
Are treats allowed?
*
Yes
No
Only specific treats
Will you bring your dog's food?
*
Yes
No
Water habits
Sleeping routine
Crate experience
*
Comfortable
Some experience
No experience
Not sure
Potty schedule and signals
Exercise preferences, favorite toys, or comfort items
Behavior & Social Information
Does your pet show separation anxiety?
*
No
Yes
If yes, what signs does your pet show when left alone?
What temperament best describes your pet?
Does your pet have any fears or triggers? If yes, please describe.
Has your pet ever bitten, snapped, or acted aggressively toward people or animals?
*
No
Yes
If yes, please describe what happened and how recently it occurred.
Is your pet an escape artist or prone to fence climbing?
*
No
Yes
Does your pet show resource guarding (food, toys, beds, or people)? If yes, please describe.
What helps your pet settle, relax, or feel comfortable?
How does your pet behave around other dogs?
May your pet socialize with resident dogs?
*
Yes
No
Pickup Authorization
Authorized Pickup Persons
*
Additional Pickup Instructions
Policies & Consent
Emergency veterinary care authorization
*
I authorize The Bearded Dog to obtain emergency veterinary care if I cannot be reached
I understand I am responsible for all veterinary and other authorized costs
No, I do not authorize emergency veterinary care
Boarding dates acknowledgment
*
I understand boarding dates are a request until confirmed by The Bearded Dog
I understand availability is not guaranteed until confirmed
I agree to wait for booking confirmation
Photo and social media permission
I consent to photos/videos of my dog being used for photos or social media
I do not consent to photos/videos being used publicly
I consent only to private internal use
Information accuracy acknowledgment
*
I certify that the information provided is true, complete, and accurate to the best of my knowledge
Typed signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
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