First Time Guest Registration

I am interested in:

Daycare
Boarding
Grooming

Parent Full Name *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Contact Name *

Primary Phone *

Alternative Contact Name

Alternative Phone

Emergency Information

Emergency Contact Name (must be available in your absence) *

Emergency Contact Primary Phone *

Emergency Contact Alternative Phone

Veterinarian’s Office

Veterinarian’s Phone

Veterinarian’s Office Address

Address Line 1

Address Line 2

City

State

Zip Code

Guest Information

Guest Name (Dog) *

Birthday

Breed

Color

Sex *

Male
Female

Spayed or Neutered? *

Yes
No

If your dog is NOT spayed or neutered, please state why below: *

Second Guest Information (If Applicable)

Guest Name (Dog)

Birthday

Breed

Color

Sex

Spayed or Neutered

If your dog is NOT spayed or neutered, please state why below:

MEDICAL HISTORY / VACCINATIONS

Written proof of current, required vaccinations (Rabies, Distemper/Parvo, and Bordatella) from your veterinarian is required. Your vet can e-mail or fax documentation prior to your visit or you can present documentation upon check-in. We recommend that vaccinations be administered at least 7 days prior to your dogs stay. If we determine that your dog has a chronic flea problem we will require proof of current flea treatment at our discretion.

Any medical history, recent or chronic, that we should be aware of? Has your dog recently been sick or under a vet’s care? Please provider details:

Name of Medication

Dose

Times Per Day

Name of Medication

Dose

Times per Day

Is your dog allergic to anything? *

If "yes", what are they allergic to?

Does your dog have any food/treat restrictions?

If "yes", what specific food to they eat?

Personality

Is your dog shy? Outgoing? Fearful? Other? (Please describe)

Is your dog protective of toys, food or anything else? If "Yes", then please explain

Has your dog ever played with other dogs in a large group setting, like another doggy daycare or a dog park?

If "yes", how did it go?

Has your dog ever shown aggression toward another dog or person?

If "yes", describe the circumstances surrounding the aggressive behavior.

Has your dog ever been involved in a fight with another dog?

If "yes", describe the circumstances surrounding the incident.

Is there any behavioral or personality information we should know about your dog to protect them and the other guests?

Will anyone other than yourself ever pick up your dog? If yes, please state their names below

Name *

First

Last

How did you hear about us? *

Client Referral? What's their name? We want to thank them for inviting you to visit us!

Photo of Guest

Click or drag a file to this area to upload.

Vaccination Pdf

Click or drag a file to this area to upload.

Date / Time

Date

Time

First Time Guest Registration