Daycare Application
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Number
*
-
Area Code
Phone Number
Cell Number
*
-
Area Code
Phone Number
Work Number
-
Area Code
Phone Number
What veterinarian do you go to?
*
Veterinarian’s phone number
*
-
Area Code
Phone Number
Is there someone else in the home we may contact if needed?
*
Yes
No
Secondary contact
*
First Name
Last Name
Secondary contact phone
*
-
Area Code
Phone Number
Emergency contact
*
First Name
Last Name
Emergency phone
*
-
Area Code
Phone Number
How many dogs are in need of daycare?
*
please answer 1-4
Name of dog #1
*
How long have you had dog #1
*
Where did you get dog #1?
*
Sex of dog #1
*
Male
Female
Is dog #1 spayed/neutered?
*
Yes
No
Is dog #1 a rescue?
*
Yes
No
What is dog #1’s birthdate?
*
-
Month
-
Day
Year
Date
What is dog #1’s primary breed?
*
What is dog #1’s primary color?
*
What is dog #1’s weight in pounds?
*
What is dog #1’s energy level?
*
Very Low
Low
Medium
High
Very High
Is dog #1 crate trained?
*
Yes
No
Does dog #1 like their crate?
*
Yes
No
Please select any attributes that accurately represent dog #1’s personality.
*
Playful
Outgoing
Shy
Submissive
Affectionate
Insecure
Gentle
Quite
Mouthy
Jumpy
Avid Barker
Excitable
Please indicate any situations that may result in dog #1 becoming unfriendly or where they may react in a negative manner.
*
Grabbing their collar
Hugging
Being removed from furniture
Being touched while sleeping
Touching ears
Touching paws
Touching tail
Being pet
Removing toy from mouth
Other
Name of dog #2
*
How long have you had dog #2
*
Where did you get dog #2?
*
Sex of dog #2
*
Male
Female
Is dog #2 spayed/neutered?
*
Yes
No
Is dog #2 a rescue?
*
Yes
No
What is dog #2’s birthdate?
*
-
Month
-
Day
Year
Date
What can you tell us about dog #2’s history?
*
What is dog #2’s primary breed?
*
What is dog #2’s primary color?
*
What is dog #2’s weight in pounds?
*
What is dog #2’s energy level?
*
Very Low
Low
Medium
High
Very High
Is dog #2 crate trained?
*
Yes
No
Does dog #2 like their crate?
*
Yes
No
Please tell us what dog #2's interests are.
*
Running
Playing with balls
Playing with toys
Jumping
Tricks
Eating
Sleeping
Other
Please select any attributes that accurately represent dog #2’s personality.
*
Playful
Outgoing
Shy
Submissive
Affectionate
Insecure
Gentle
Quite
Mouthy
Jumpy
Avid Barker
Excitable
Please indicate any situations that may result in dog #2 becoming unfriendly or where they may react in a negative manner.
*
Grabbing their collar
Hugging
Being removed from furniture
Being touched while sleeping
Touching ears
Touching paws
Touching tail
Being pet
Removing toy from mouth
Other
Name of dog #3
*
How long have you had dog #3
*
Where did you get dog #3?
*
Sex of dog #3
*
Male
Female
Is dog #3 spayed/neutered?
*
Yes
No
Is dog #3 a rescue?
*
Yes
No
What is dog #3’s birthdate?
*
-
Month
-
Day
Year
Date
What can you tell us about dog #3’s history?
*
What is dog #3’s primary breed?
*
What is dog #3’s primary color?
*
What is dog #3’s weight in pounds?
*
What is dog #3’s energy level?
*
Very Low
Low
Medium
High
Very High
Is dog #3 crate trained?
*
Yes
No
Does dog #3 like their crate?
*
Yes
No
Please tell us what dog #3's interests are.
*
Running
Playing with balls
Playing with toys
Jumping
Tricks
Eating
Sleeping
Other
Please select any attributes that accurately represent dog #3’s personality.
*
Playful
Outgoing
Shy
Submissive
Affectionate
Insecure
Gentle
Quite
Mouthy
Jumpy
Avid Barker
Excitable
Please indicate any situations that may result in dog #3 becoming unfriendly or where they may react in a negative manner.
*
Grabbing their collar
Hugging
Being removed from furniture
Being touched while sleeping
Touching ears
Touching paws
Touching tail
Being pet
Removing toy from mouth
Other
Name of dog #4
*
How long have you had dog #4
*
Where did you get dog #4?
*
Sex of dog #4
*
Male
Female
Is dog #4 spayed/neutered?
*
Yes
No
Is dog #4 a rescue?
*
Yes
No
What is dog #4’s birthdate?
*
-
Month
-
Day
Year
Date
What can you tell us about dog #4’s history?
*
What is dog #4’s primary breed?
*
What is dog #4’s primary color?
*
What is dog #4’s weight in pounds?
*
What is dog #4’s energy level?
*
Very Low
Low
Medium
High
Very High
Is dog #4 crate trained?
*
Yes
No
Does dog #4 like their crate?
*
Yes
No
Please tell us what dog #4's interests are.
*
Running
Playing with balls
Playing with toys
Jumping
Tricks
Eating
Sleeping
Other
Please select any attributes that accurately represent dog #4’s personality.
*
Playful
Outgoing
Shy
Submissive
Affectionate
Insecure
Gentle
Quite
Mouthy
Jumpy
Avid Barker
Excitable
Please indicate any situations that may result in dog #4 becoming unfriendly or where they may react in a negative manner.
*
Grabbing their collar
Hugging
Being removed from furniture
Being touched while sleeping
Touching ears
Touching paws
Touching tail
Being pet
Removing toy from mouth
Other
Have any of your dogs ever climbed a fence?
*
Yes
No
Have any of your dogs gone to daycare before? If yes, please explain.
*
Have any of your dogs ever bitten a person? If yes, please describe.
*
Have any of your dogs ever bitten another dog? If yes, please describe.
*
Do any of your dogs guard resources (ie. food, toys,treats,or people)? If yes, please describe.
*
Do any of your dogs have any health, allergies or dietary restirictions we should be aware of? Please explain.
*
Do any of your dogs go to dog parks?
*
Yes
No
Have any of your dogs ever exhibited aggressive behavior towards other dog/people are the park such as mouthing, teething, fighting, or raising hackles?
*
Are there any people your dog(s) dislike or fear?
*
How do your dogs react to small dogs or puppies?
*
Have any of your dogs ever growled or snapped at anyone who has tried to take food or toys away?
*
Special instructions or other information we should know about
*
Do you mind if your dog gets wet or plays in a dog pool or is giving a bath if we feel it is needed?
*
When would you like to bring your dog(s). We are open three days a week at this time. Tuesday-Thursday 7am-6pm
*
Rows
Tuesday
Wednesday
Thursday
Full day
Half day
Please list anyone you are giving permission to pick up your dog from daycare. Name, relationship and phone number. Photo ID will be required to pick up you odg.
*
How did you hear about us?
*
Please upload a picture of your dog.
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