Daycare Agreement

1

Name

First Name

Last Name

2

Dog's Name(s)

3

Today's Date

Date

4

Terms and Conditions* This field is required.

5

Emergency ContactIn the event of an emergency, injury, or illness: TCVH will try to contact the owner before administering treatment. If the owner cannot be reached, please leave an emergency contact name and number for a person who is allowed to make medical decisions for your pet in your absence.

Name and phone number

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In the event that the owner AND the emergency contact cannot be reached, please leave a dollar amount that TCVH has permission to treat your pet with.This would be a budget to begin treatment with while awaiting a phone call from owner and emergency contact.

Dollar amount

7

What flea and tick prevention is(are) your pets receiving and when was it last given?

Flea/Tick Prevention

Date Given

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Do you want your pet(s) to receive their flea/tick prevention the first day of the month while they are at daycare?Selecting yes will add them to a list of clients who's flea/tick prevention is given at the facility the first day they are here after the 1st of the month. Selecting yes indicates you're aware you're responsible for the charges associated on that day.

YESNO

9

Does your pet receive Librela injections? If you'd like that done while at daycare, please indicate the date you would like it scheduled.Selecting yes indicates you're aware you're responsible for the charges associated on that day.

No

Yes and date you'd like it scheduled for

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Does your pet receive Cytopoint injections? If you'd like that done while at daycare, please indicate the date you would like it scheduled.Selecting yes indicates you're aware you're responsible for the charges associated on that day.

No

Yes and date you'd like it scheduled for

11

If your pet is due for annual vaccines this month and you would like it done while at daycare, please indicate the date you would like it scheduled.Pets are required to be current on Rabies, Distemper, and Bordetella vaccines. Lepto, Heartworm tests, and annual bloodwork are recommended to be kept current but not required for daycare attendance.

Not Applicable this Month (No)

Yes, date you'd like it scheduled, & full annual or what's required?

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What days of the week are you anticipating your dog(s) to be here throughout this month?If your dog typically comes on a schedule, feel free to let us know so we can plan ahead!

Monday

Tuesday

Wednesday

Thursday

Friday

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We're planning to launch a daycare and boarding mailing list, would you like to be added?It's important to know that you would not be spammed. It would be purely informational, likely the first of each month moving forward. It would contain things like fun activities we'll be doing, get to know that staff bios, schedule changes/adjustments, photo/video dumps for you to have, etc. You do not have to be added but, it's a fun little thing I've wanted to do for clients for a while and will be adding to our routines!

If you'd like to be added to the email list, please leave the email you would like the monthly news letter sent to here^

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SignatureSigning here indicates you understand TimberCreek's Daycare Agreement and agree to be responsible for any charges acquired through extra services.

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