APPLICATION FOR ENROLLMENT
Please complete the following questions to the best of your knowledge. This information will
help us maintain a safe and fun environment for all guests. We are concerned not only about
your dog's safety and health, but also that of our other guests and our team members. Please
take a few moments to tell us about yourself and your dog. Thank you.
CLIENT INFORMATION
Name: ______________________________________ Address: _________________________________________________________
City, State, Zip: ______________________________ Email: ________________________________________________________
Cell Phone: ____________________________
Home Phone: _______________________________
Work Phone: ___________________________
Other Phone: _______________________________
Pet Information:
Name/Nick names: _______________________________________
Breed: ______________________________________
Weight: _____ lbs.
Gender: M / F
Color and Markings: _____________________________
Age _____ years, _____ months
Feeding Schedule: ____________________________
Microchip Y / N
Spayed/Neutered? Y / N
Brand/Type of Dog Food: ________________________________
Are there any restrictions on the type of treats your dog can have? ______________________________________
How long have you had your dog? _________ If you have not had her/him from puppyhood, what do
you know of your dog’s prior history? ______________________________________________________________________
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Please describe your dog’s overall temperament: __________________________________________________________
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Does your dog have any health concerns? __________________________________________________________________
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Does your dog have any medical restrictions? ______________________________________________________________
If your dog is currently on any medication, please describe: _____________________________________________
If your dog has any allergies, please list: ____________________________________________________________________
Does your dog receive flea and tick preventative? Y / N
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Heartworm? Y / N
Additional Contact Information:
Is there another Pet Owner? Y / N
Relationship to You? ______________________________________________
Name: ______________________________________ Address: _________________________________________________________
City, State, Zip: ______________________________ Email: ________________________________________________________
Cell Phone: ____________________________
Home Phone: _______________________________
Work Phone: ___________________________
Other Phone: _______________________________
Emergency Contact Information:
Relationship to You? _______________________________________
Name: ______________________________________ Address: _________________________________________________________
City, State, Zip: ______________________________ Email: ________________________________________________________
Cell Phone: ____________________________
Home Phone: _______________________________
Work Phone: ___________________________
Other Phone: _______________________________
Authorized Pick Up/Drop Off:
Name(s) and Cell Phone # (s) _______________________________________________________________________________
Vet Information:
Vet Office Name: ______________________________________ Is there a preferred Dr.? ___________________________
Vet Telephone Number _________________________ Vet Fax Number ___________________________
Vet’s Emergency Number ______________________ Vet Email ___________________________________
Please have your vet provide verification of the most recent vaccination information:
1. Rabies Vaccination: Current within the last 1-3 years (based on life of your pets' particular vaccine)
2. DHPP Vaccination: Current within the last 1-3years (based on life of your pets' particular vaccine)
3. Bordetella Vaccination: Current within the last 6 months
DAYCARE INFORMATION
Behavior Details:
How does your dog react to other dogs? ____________________________________________________________________
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Has your dog participated in play with other dogs? Y / N If so, how does your dog react? ____________
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How does your dog react to strangers?
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What are your dog’s fears or dislikes (dog, persons or circumstances such as thunder)? ______________
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Has your dog ever bitten a person or a dog? Y / N Has your dog ever been bitten or in a fight? Y/ N
Has your dog ever escaped or attempted to escape by digging or climbing fences? Y / N
Can your dog jump over a 6-foot-high fence? Y/N
Does your dog have any behavioral problems? _____________________________________________________________
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How would you calm your dog? ______________________________________________________________________________
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Is your dog housebroken? Y / N
Is your dog food possessive? Y /N
Crate-trained? Y / N
Is your dog toy possessive? Y / N
Does your dog play with toys, and if so what kind? ________________________________________________________
Has your dog shared toys, food, water with other dogs previously? Y / N
Is there any play equipment you do not want your dog to use? __________________________________________
Has your dog ever received any formal training? Y / N
What commands does your dog know? Any special commands such as bathroom command, quiet
command, play command? ___________________________________________________________________________________
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Which activities make your dog happy? _______________________________________________________________
How would we recognize when your dog is anxious? ________________________________________________
Does your dog have any areas on his or her body that he or she does NOT like to be touched? Y / N
If YES, please describe _______________________________________________________________________________________
Does your dog have a special place that he or she likes to be petted or rubbed? Y / N If YES, please
describe:
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GROOMING INFORMATION
How does your dog respond to grooming? __________________________________________________________________
How does your dog respond to getting a bath? _____________________________________________________________
How does your dog respond to getting brushed? __________________________________________________________
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How does your dog respond to nail trimming? _____________________________________________________________
Is there anything that you do that make these activities more enjoyable? ______________________________
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Does your dog require any special shampoo or brush? ____________________________________________________
Special notes about my dog for the groomer: _______________________________________________________________
BOARDING INFORMATION
Feeding Details:
What time(s) does your dog usually eat? __________ Is your dog a good eater away from home? Y / N
Describe what we can do to encourage your dog to eat, such as adding wet food, or water. ___________
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Does your dog have any food restrictions? Y / N If YES, please describe: _______________________________
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What are your dog’s feeding instructions:
Dry Food Type: ____________________________ Amount per meal: _____________ Frequency ___________________
Wet Food Type: ____________________________ Amount per meal: _____________ Frequency ___________________
If you have multiple dogs, do they need to be fed separately if sharing a suite? Y / N
Do you have any special instructions for your dog’s boarding caregiver? ________________________________
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Medication Instructions:
Which medications does your dog need during boarding? ________________________________________________
What is the frequency of each medicine? ___________________________________________________________________
Do you have any special instructions regarding medication? _____________________________________________
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Sleeping Arrangements: We offer three types of overnight accommodations: Kennel Suites,
Cozy Crates, or a Slumber Party with our Night Staff on a Plush Dog Bed (No Kennel or Crate). Does
your dog have a preference? Y/N If Yes: Kennel Suite / Cozy Crate / Slumber Party Dog Bed
General:
Do you have any special “tuck-in” instructions for your dog’s boarding caregiver? _____________________
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Is there anything else we should know about your dog? ____________________________________
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