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All About Dogs_ LLC

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									All About Dogs of Northeast Ohio, LLC Guest Application
FOR OFFICE USE ONLY: Enrollment form________ Computer entry________ Daycare ____________ Over night __________ Shots checked_________ Folder made___________

Phone: 440-708-1364 17078 Munn Road Unit #7 Auburn Twp., OH 44023

Other _______________ Temperament _________ Picture taken__________

Please complete the following questions. This information will help us maintain a comfortable environment while your dog is our guest. We are not only concerned about your dog’s safety and health, but also the other dogs and staff members that will be here during your dogs stay. Please take a few moments to tell us about yourself and your best friend. Thank you.

Client Information
Last Name ______________________________ First Name______________________ Street address _______________________________________________Apt#_______ City___________________________________ State _______________Zip ________ Home Phone _____________________________ Work Phone______________________________ Cell Phone _______________________ Emergency contact name_____________________________________________________ Emergency contact phone number______________________________________________ Email address_____________________________________________________________ Please list the name(s) of those authorized to drop off/pick up your dog (We will only release your dog to the names listed below) _______________________________________________________________________________ _______________________________________________________________________________ How did you hear about us? __________________________________________________________________

Dog’s General Information
Dog’s Name _____________________________ Breed _________________________________ Birth date ______________________________ Is your dog spayed or neutered? _____________ Color __________________________________ Nickname _______________________ Age____________________________ Please circle: Male Female Date of surgery___________________ Weight _________________________

Dog’s Health Information Veterinarian: Dr.__________________ at __________________Clinic/Hospital Address________________________________________________________ Clinic phone number________________ Clinic fax number__________________ Vaccinations
Rabies DHLPP Bordatella Fecal test __________ __________ __________ ___________ Date Administered Date Administered Date Administered Results of test __________ __________ __________ __________ Date Due ________ Date Due ________ Date Due ________ Date Due _______

All About Dogs of Northeast Ohio, LLC Guest Application

Phone: 440-708-1364 17078 Munn Road Unit #7 Auburn Twp., OH 44023

Is your dog on a flea prevention program? Yes No Brand used and last date administered ___________________________________________ Is your dog on heartworm prevention? Yes No Brand used and last date administered ____________________________________________ Does your dog have any hip/joint problems or activity restrictions? Yes No If yes, please describe _____________________________________________________________ _______________________________________________________________________________ Please describe your dog’s general health.________________________________________________ _______________________________________________________________________________ If you have more than one dog, do they need to be fed in separate areas from one another? Yes No Does your dog have any known allergies or food restrictions? _______________________________________________________________________________ ** As an over night guest please note, if your dog runs out of food during his/her stay, All About Dogs will purchase their brand of dog food (or similar) and the purchase price will be added to your final invoice. Please list any current medications your dog is taking and the frequency and time administered. _______________________________________________________________________________ _______________________________________________________________________________ Is your dog allowed to have dog biscuits and training treats provided by All About Dogs? Yes No May we use photographs of your pet for advertising purposes ? Yes No How long has your dog been a member of your family? ______________________ Where did you get your dog from? ____________________________________ Has your dog ever attended day care or been boarded before? Yes No If so, where? ___________________________ Is your dog licensed with your county auditor? Yes No Dog license number____________________ Does your dog have a microchip? Yes No Where does your dog typically sleep? crate floor furniture dog bed What are your dog’s favorite activities/toys? ____________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

PLEASE NOTE:
***In case of an emergency situation or injury, you or your emergency contact will be notified immediately. If immediate emergency medical attention is required, we will transport your dog to the nearest emergency veterinarian facility, along with contacting your veterinarian office. If the situation does not require immediate attention, we will contact you and take action according to your instructions.

All About Dogs of Northeast Ohio, LLC Guest Application
Dog’s Behavior Information

Phone: 440-708-1364 17078 Munn Road Unit #7 Auburn Twp., OH 44023

Has your dog had any basic obedience training? ___________________________________________ Please circle known commands: sit down stay wait settle come off Other known commands, hand signals, or tricks ___________________________________________ ______________________________________________________________________________ What commands or behavior issues would you like us to work on while your dog is with us? _______________________________________________________________________________ _______________________________________________________________________________ How does your dog react to other dogs approaching when you’re out on a walk? _______________________________________________________________________________ When on a walk, does your dog frequently urinate or lift his leg often to mark territory? _______________________________________________________________________________ Please check the following behaviors that apply to your dog:  separation anxiety  toy/food possessive  sensitive to touch  excessive barking  not housebroken  escape behavior/runs away  destructive/chewing  mouthiness  jumps on people  coprophagia (eats stool)  fear of loud noises  climbs over/digs under (thunder) fences Does your dog have any sensitive areas on his/her body that he does not like touched? _______________________________________________________________________________ How does your dog react to new people/dogs coming into your house? _______________________________________________________________________________ Are you able to remove things from your dog’s mouth? ______________________________________ Has your dog had any socialization with other dogs? ________________________________________ *Has your dog ever bitten another dog or person? _________________________________________ *Has your dog growled or snapped at another dog or person? _________________________________ *Is your dog fearful or aggressive around certain types of dogs or people? ______________________ (If Yes to *, please explain): _________________________________________________________ _______________________________________________________________________________ When your dog needs to go potty he/she will typically: Bark whine sit by door pace around door ring bell on door What phrase or word do you use as a command for your dog to eliminate? (Such as “go potty”) _______________________________________________________________________________ Was your dog crate-trained as a puppy? Yes No Do you still use a crate in your home now? Yes No Is your dog afraid of any specific items or noises? Yes No If yes, please describe, and let us know what you do to calm your dog at home. ______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Are there any other special needs, comments, or information about your dog that you feel might be helpful for us? _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

All About Dogs of Northeast Ohio, LLC Guest Application
PLEASE READ THE FOLLOWING STATEMENTS and INTITAL EACH.

Phone: 440-708-1364 17078 Munn Road Unit #7 Auburn Twp., OH 44023

____ 1. I understand that All About Dogs Doggy Daycare has relied on my information provided and that my dog(s) is/are in good health, and has not had any communicable condition in the last 30 days. I also understand, and am aware that vaccines do Not protect against all communicable illnesses. ____ 2. I understand that I am solely responsible for, and hold All About Dogs of Northeast Ohio, LLC and their staff, NOT liable for any problem, harm or damage caused by my dog(s) or to my dog by another dog during his/her stay, provided reasonable precautions and care are provided and I hereby release All About Dogs of Northeast Ohio, LLC from all liability of any kind whatsoever. ____ 3. I understand that if any emergency situation or problem develops with my dog(s), All About Dogs’ will provide treatment as deemed best by the staff, and I will assume full financial responsibility for any and all expenses involved in the treatment of my dog. I understand that the staff will contact me or the designee I have provided as soon as possible in the event of an emergency. _____4. All About Dogs is authorized, at their discretion, to seek medical attention for my dog if deemed necessary. I am aware that a credit card will be imprinted and attached to my dogs over night boarding file. This credit card will be charged in the unlikely event that veterinary care is necessary. I agree to pay all veterinarian charges associated with my dog’s medical care during their stay. I hereby give All About Dogs permission to have any medical treatment costs charged to the credit card I have provided. _____ 5. I confirm that my dog has never harmed or shown un due aggression or threatening behavior towards any other dog or person. I understand that All About Dogs of Northeast Ohio, LLC reserves the right to refuse or revoke admittance to any dog that does not meet the temperament or health requirements set forth above. I am also aware that at any given time if my dog shows aggressive tendencies towards another dog or staff member I will be contacted and asked to pick my dog up as soon as possible. If I am unavailable to come and get my dog or dog’s, I understand it is my responsibility to make arrangements to have someone come to get my dog. At that time we will reevaluate my dog or dog’s enrollment to daycare/ over night boarding. _____6. I understand that I am liable for any damage that my dog may cause during his/her stay at All About Dogs. I agree to pay for the repairs caused by damage done by my dog that would leave an area unsafe for my dog or other future guests. I certify that I have read and understand the rules and policies of All About Dogs Doggy Daycare and Over night boarding and accept the terms and conditions of this agreement. _______________________________ Owner’s Signature(s) ____________________ Date


								
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