Daycare Appointment

Vet / Other Contacts / Privacy
Veterinarian or Clinic *
Vet Phone

Area Code Phone Number
Emergency Contact *

First Name Last Name
Emergency Contact Phone *

Area Code Phone Number
Authorized Caretakers
Names and phone numbers of all persons who are authorized to pick up your dog
Image privacy *

I grant permission to post pictures of my dog(s) with their name on K9CET's website, on social media (Facebook, Instagram, etc.) and/or in other print and video/TV media related to K9 Center TN I grant permission to post pictures of my dog(s) without their name on K9CET's website, on social media (Facebook, Instagram, etc.) and/or in other print and video/TV media related to K9 Center I prefer images and videos are not used of my dog (s)

Health and Feeding (Dog #1)
Please note any physical conditions we need to be aware of
Lump, hot spot, injury, lameness, etc.
Feeding routine (when to feed: morning nap time, afternoon nap time. Please don't bring more than 1/2 cup servings as we don't have a way to store food at the center)
Add all feeding details and special instructions
This dog requires medication(s) during daycare (next page for details)

Yes No

Health and Feeding (Dog #2)
Please note any physical conditions we need to be aware of
Lump, hot spot, injury, lameness, etc.
Feeding routine (when to feed: morning nap time, afternoon nap time. Please don't bring more than 1/2 cup servings as we don't have a way to store food at the center)
Add all feeding details and special instructions
This dog requires medication(s) during daycare (next page for details)

Yes No

For Multiple Dogs
How well do your dogs get along with each other? *

N/A My dogs are fine together, they can be in the same area My dogs can play together, but need to be fed separately My dogs should be in separate but adjacent areas My dogs need to be in separate areas that aren't adjacent

You're almost finished!

We require the following vaccinations for all dogs on the premises:
- Rabies
- Annual booster (DHLPPC or equivalent) or puppy series
- Bordetella
- Canine Influenza (bivalent form highly recommended)
Vaccination information *

K9CET should already have vaccination records for dog(s) Vaccination records are being emailed to K9CET at vetrecords@k9centertn.com (recommended) I am bringing vaccination records when I drop off my dog(s)
Please use this space for special requests, notes or comments

Waiver & Signature
1. I understand this is a facility where my dog(s) may engage physically with other dogs in daycare.
2. I understand that my dog(s) may be subject to injury, muscle fatigue, and/or sore pads due to excessive play during daycare.
3. I understand that dogs are unpredictable and may behave in ways that subject themselves and other dogs to risks in this facility, even if all dogs have been previously assessed for good temperament.
4. I understand that misters and baby pools are used during warm weather to keep the dogs cool. My dog may be damp or wet when picked up.
I agree with the statements above. *

I agree I do not agree
By e-signing this form, I accept the risks in the statements in the waiver above and I certify that the information provided in this form is accurate and true to the best of my knowledge. *

Sign this form electronically Clear
Please click SUBMIT button below to complete your request.

To see current pricing and to pre-purchase online, go to:

K9CET

or copy/paste this address in your browser:

http://k9centertn.com

Thank you for requesting our free daycare trial appointment!

You should receive a response within 24 hours from our Daycare Director (possibly longer over the weekends). Please be sure you've received an email from our office confirming your requested date and time before arriving.
Should be Empty:

	Yes	Somewhat	No	Unsure
Currently on flea/tick prevention
Afraid of loud noises, thunder
Does your dog go to a dog park?
Does your dog bark constantly?
Jumps or climbs fences **SEE NOTE above
Does your dog hump other dogs?
Plays well with Male dogs?
Plays well with Female dogs?
Digs under fences
People aggressive/reactive
Skittish around men
Skittish around women
Skittish around children
Skittish around strangers
Dog aggressive/reactive
Cat or other small animal prey drive
Destroys bedding, toys
Has a record as a 'dangerous dog'
Has had obedience training
Has had lots of dog socialization
Does your dog have updated canine flu and bordetella shots?

	Yes	Somewhat	No	Unsure
Currently on flea/tick prevention
Afraid of loud noises, thunder
Jumps or climbs fences
Digs under fences
Does your dog bark constantly?
Does your dog go to a dog park?
Jumps or climbs fences **SEE NOTE above
Does your dog hump other dogs?
Plays well with Male dogs?
Plays well with Female dogs?
People aggressive/reactive
Skittish around men
Skittish around women
Skittish around children
Skittish around strangers
Dog aggressive/reactive
Cat or other small animal prey drive
Destroys bedding, toys
Has a record as a 'dangerous dog'
Has had obedience training
Has had lots of dog socialization
Current on Canine Flu and Bordetella vaccines?

Doggy Daycare Registration