Dog's Name
*
Breed
*
Colour
*
Dog's Gender
*
Select One
Female
Male
Dog's Birthday
*
MM
DD
YYYY
Owner's Name
*
First Name
Last Name
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Cell Phone
(###)
###
####
Other Phone
(###)
###
####
Emergency Contact
*
Emergency Contact - Phone #
*
(###)
###
####
Last Bordetella Date
*
This is an annual shot. Dogs must have this to attend daycare.
MM
DD
YYYY
Spayed/Neutered Date
All dogs over 8 mths old must be spayed or neutered
MM
DD
YYYY
Brand of Food
Allergies
Medication
What is the medication for?
Does your dog visit any other daycares or dog parks?
Has your dog had much dog interaction?
How does your dog react to other dogs for the first time? Is there any type of dog your dog doesn’t like? (i.e. big dogs, small dogs, vocal dogs…)
Has your dog ever bitten a person or animal causing injury?
Has your dog ever been in a dog fight? Even if it was not their fault?
Is there a type of person your dog is afraid of (i.e. males, taller people)?
If yes, please describe
Please describe how your dog reacts when strangers arrive at your home:
Has your dog ever tried to jump/climb a fence?
Where is your dog when you are not home? (i.e. crate, living room, fenced back yard, run of the house)
Is your dog crate trained?
Have you ever experienced any difficulties with any of the following behaviours?
(Check all that apply)
How active is your dog?
Does your dog play with toys? With other dogs?
Unusual Habits: Food or Object Possessiveness
(Check all that may apply)
How does your dog behave on leash?
(Check all that may apply)
What type of collar or harness do you use when walking and training your dog?
(Check all that may apply)
Has your dog had any formal training?
Are there any behaviours or manners you are currently trying to work on with your dog?
What are you looking to get out of your experience here at Pawsitive Daycare?
How did you hear of our daycare service?
Select one
Referral
Word of mouth
Search Engine
Facebook
Other
I acknowledge that there are certain health and personal injury risks associated with getting a group of dogs and people together in a daycare type situation – i.e.. fleas, puppies jumping on people, puppies nipping each other, strained muscles, scratches etc. I completely absolve Pawsitive Daycare and its employees of any liability for any injury/ health problem sustained by person or animal while participating in daycare activities. In case of an emergency situation every effort will be made to contact the dog’s owner, however if owner contact not possible right away- I authorize emergency services to be performed at and will take responsibility for payment.
*
I will ensure my dog is wearing a flat quick release collar while attending daycare. I will NOT drop my dog off with martingales, leather collars, spikes, scarf etc.
*
Today's Date
MM
DD
YYYY
Thank you for your interest is Pawsitive Daycare, and for your patience in completing our application.
We have received your information and will be in touch soon.
Have a pawsitive day!
