The Dog House
Doggie Daycare
Pet Profile Enrollment Form
Please return this
completed form along with a copy of your pet(s)
vaccination records to our mailing
address:
The Dog House Doggie
Daycare
Phone 828-252-2323
Welcome to the Dog House! Please complete
the information below so that we may provide the best possible care for your
pet.
Note that for the health and safety of
all our guests, all dogs over 6 months of age must be spayed or neutered and be
current on rabies, DHLPP, and Bordatella
vaccinations. Under 6 months, all pets must have their first course of puppy
shots.
All dogs MUST be on a flea and tick
preventative.
General Information:
Date:_____________________
How
did you hear about us?_________________________________________________
Owner’s
Name:_______________________________Pet’s
Name:__________________
Owner’s
Address:
_______________________________________________________________________
Home
Phone:____________________Daytime
or Work Phone:____________________
Emergency
Contact Name:_______________________Phone:_____________________
Breed:___________________Sex:__________Age:__________Birthday:____________
Is
your dog spayed/neutered? Yes______ No______
Where
did you get your dog?________________________________________________
What age was your dog when you got him/her?_________________________________
Veterinary Information:
Name
of
Name
of Vet most familiar with your dog:____________________________________________
Address:______________________________________________________________________
Phone:___________________________
Health:
Does
your dog have any problems with ticks or fleas?__________________________________
Flea
or tick preventative product used:_______________________________________________
Does
your dog have arthritis, joint problems or hip dysplasia? Yes______ No______
If
you answered yes, please explain:_________________________________________________
Are
there any restrictions on your dog’s movements or activities?_________________________
______________________________________________________________________________
Is
there a history of medical problems (i.e., seizures) that we should be alert
to?
Yes____
No_____
If
you answered yes please explain:_________________________________________________
List any medications your dog takes:________________________________________________
Behavior:
How
does your dog react to strangers?_______________________________________________
How
does your dog react to other dogs?______________________________________________
Please
describe any problems that your dog has had with any of the following:
Barking:_______________________________________________________________________
Jumping:______________________________________________________________________
Mouthing
(grabbing but not biting):_________________________________________________
Housetraining:__________________________________________________________________
Leash
training or leash pulling:_____________________________________________________
Does
your dog growl, snap at or bite someone for approaching their toys or food:
Yes_____ No_____
If
yes, please describe the circumstances:_____________________________________________
______________________________________________________________________________
Has
your dog ever been attacked or bitten by another dog? Yes______ No_______
If
so, please describe the circumstances:_____________________________________________
______________________________________________________________________________
How
does your dog react to being crated?____________________________________________
Has
your dog had any formal obedience/good-manners training? Yes______ No______
If
so, where and when:___________________________________________________________
What
commands does your dog know?______________________________________________
_____________________________________________________________________________
Final Details:
Please
detail any other information about your pet that you feel would be helpful or
important to The Dog House staff:_____________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
I certify that I have
answered the above questions fully and to the best of my
ability.
______________________________________________ __________________
(Owner’s
Signature)
(Date)
The Dog House Doggie Daycare
Phone 828-252-2323
STANDARD AGREEMENT
Owner’s
Name_______________________________________________________________________________________________
Address_____________________________________________________________________________________________________
City_________________________________________________________State________________________Zip________________
Home ( )________________________________________________
Work (
)____________________________________
Mobile ( )________________________________________________Pager
( )____________________________________
Emergency Contact_____________________________________________Phone
( )___________________________________
Veterinary Office_______________________________________________Phone( )___________________________________
Dog’s
Name___________________________________________________Gender____________________D.O.B._______________
Dog’s
Breed_____________________________________ Color______________________________Spayed/Neutered:
Y/N________
1.
The
Facility agrees to exercise due diligence and reasonable care, and to keep the
premises sanitary and properly enclosed. All pets are handled or cared for by
Facility staff without liability on Facility’s part for loss or damage from
disease, theft, fire, death, escape, injury or harm to persons, other pet(s) or
property by said pet, or from other unavoidable causes, due diligence and care
having been exercised.
2.
Should
any pet become ill or seem to be in need of medical consideration, within the
sole discretion of the facility staff, the Facility reserves the right to
administer aid and/or to use the veterinarian specified by the Owner, or any
other veterinarian if necessary. The owner will be notified if possible. Any
expenses so incurred shall be paid by the Owner of said pet in addition to
other fees incurred for services provided at or by the Facility.
3.
Owner
agrees to pay the rate for services in effect on the date their pet is checked
into the Facility. Prices are subject to change at any time, without notice.
Cancellation fees may be applied for reservations cancelled less than 24 hours
prior to a scheduled reservation. The Owner shall remain liable for all charges
incurred for the care and maintenance of the pet listed on this contract. It is
expressly agreed that the Facility’s liability shall in no event exceed the sum
of $200.00 per animal. The Owner further agrees to be solely responsible for
any and all acts or behavior of said pet while in the care of the Facility. The
Owner of the pet agrees to pay reasonable attorney fees incurred by the
Facility in the collections of any charges for services incurred by the Owner
of the pet.
4.
Pets
must be in good general health and remain current on Rabies, DHLPP, and Bordatella vaccinations, according to their veterinarian’s
recommendation, when dropped off for any service provided at or by the
Facility. The Owner must provide valid proof of all required vaccinations prior
to the pet’s first visit, when vaccinations are updated, and/or annually. Pets
must also be on a prevention program for fleas and ticks, or when specifically
requested by the Facility. Pets arriving with fleas and/or ticks may be turned
away at the Owner’s expense. The Facility expressly disclaims any responsibility
for fleas or other parasites. The Facility reserves the right to refuse
services or admittance to any dog for any reason.
5.
Owner agrees that Owner or a pre-approved Owner’s agent will pick up
daycare pets by
6.
Owner agrees that their pet may be videotaped, photographed, and/or
recorded. The Facility shall be the exclusive owner to the results and all
proceeds of such tapings, photography, and recordings with the rights
throughout the world, an unlimited number of times in perpetuity, to copyright,
to use and to license to others in any manner. Owner further agrees that their
pet may be used in any and all media and in the promotion, advertising, sale,
publicizing, and exploitation of the Facility.
I understand and agree to the above
conditions.
Owner’s Signature
________________________________________Date______________________