Dog Boarding - Daycare Form

Please complete all required fields!

Pet Parent Information

How did you hear about us?

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Search Word

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Name*

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Email Address*

Please type correct email address

Address*

Please, add your Address

City*

Please add your City

State*

Please add your State

Zip Code*

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Cell 1*

Please add your Cell Number

Cell 2

Home Number

Additional Numbers

Emergency contact person's name and phone number

Name

Phone Number

Veterinarian Info

Name*

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Address*

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City*

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State*

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Zip*

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Phone*

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Pet Information

Pets Name*

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Breed

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Sex*

Male

Female

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Date of Birth

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Spayed / Neutered*

Yes

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Weight

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How long have you had him / her ?

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What do you do with your dog when you leave the home?

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How does he/ she react when you get home?

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Is your dog housebroken?*

Yes

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Does your dog like to receive brushing?*

Yes

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Crate Trained?*

Yes

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Feeding Instructions

Time for feeding:

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Other

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Feeding Amount*

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Brand and Type of Food

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Is your pet allowed to have treats?*

Yes

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What Type?

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Times of the day you take your dog out to potty

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Pet Health History

Is your dog up to date on immunizations?*

Yes

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Please bring a copy of your current immunization records

Micro Chip*

Yes

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Does your dog receive flea and tick preventative*

Yes

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Brand*

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I affirm that my dog is recently bathed and on a flea and tick control product at this time*

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Is your dog on medications?*

Yes

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Instruction for medication

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Health Concerns*

Yes

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Please describe

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Does your dog have any allergies?*

Yes

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Please describe

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Special Instructions

( Chews furniture, behavioral issues, anxiety, fears or aggressions )

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Additional Services

( Bath, Training, etc... )

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Permission To Transport Pet

Owner authorizes Wag Watches, LLC and/ or their representatives to transport their pet(s) for any veterinarian care ( emergency or non-emergency), beaches, dog parks, groomer / pet taxi services*

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Dog Walking Profile

How does your dog react to other dogs? (Generally)

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How does your dog react to strangers?*

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Does your dog have any kinds of people he/ she automatically fear or dislikes?*

Yes

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Please describe

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Has your dog bitten someone?*

Yes

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Please describe

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Has your dog ever been in a fight or bitten another dog?*

Yes

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Please describe

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Is your dog allowed to play outdoors without a leash?*

Yes

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Do you walk your dog?*

Yes

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How often?*

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Distance*

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When you walk your dog, if he/ she sees another dog, does he/she:*

Ignore the other dog

Show some interests but keep walking

Wag his tail in a playful manner and wants to play

Growl and become aggressive

Pull hard on the leash in an attempt to get to the other dog

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When you walk your dog, if he/ she sees a cat or other small animal, does he/ she:*

Ignore the other animal

Show some interests but keep walking

Growl and become aggressive

Pull hard on the leash in an attempt to get to the other animal

Invalid Input

Commands your dog knows

(i.e. come, heel, halt, let's walk, etc...)

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Would you like to add an Additional Dog?*

Yes

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Additional Pet Information

Pets Name*

Invalid Input

Breed

Invalid Input

Sex*

Male

Female

Invalid Input

Date of Birth

Invalid Input

Spayed / Neutered*

Yes

Invalid Input

Weight

Invalid Input

How long have you had him / her ?

Invalid Input

What do you do with your dog when you leave the home?

Invalid Input

How does he/ she react when you get home?

Invalid Input

Is your dog housebroken?*

Yes

Invalid Input

Does your dog like to receive brushing?*

Yes

Invalid Input

Crate Trained?*

Yes

Invalid Input

Feeding Instructions

Time for feeding:

Invalid Input

Other

Invalid Input

Feeding Amount*

Invalid Input

Brand and Type of Food

Invalid Input

Is your pet allowed to have treats?*

Yes

Invalid Input

What Type?

Invalid Input

Times of the day you take your dog out to potty

Invalid Input

Pet Health History

Is your dog up to date on immunizations?*

Yes

Invalid Input

Please bring a copy of your current immunization records

Micro Chip*

Yes

Invalid Input

Does your dog receive flea and tick preventative*

Yes

Invalid Input

Brand*

Invalid Input

I affirm that my dog is recently bathed and on a flea and tick control product at this time*

Invalid Input

Is your dog on medications?*

Yes

Invalid Input

Instruction for medication

Invalid Input

Health Concerns*

Yes

Invalid Input

Please describe

Invalid Input

Does your dog have any allergies?*

Yes

Invalid Input

Please describe

Invalid Input

Special Instructions For Pet

( Chews furniture, behavioral issues, anxiety, fears or aggressions )

Invalid Input

Additional Services

( Bath, Training, etc... )

Invalid Input

Permission To Transport Pet

Owner authorizes Wag Watches, LLC and/ or their representatives to transport their pet(s) for any veterinarian care ( emergency or non-emergency), beaches, dog parks, groomer / pet taxi services*

Invalid Input

Dog Walking Profile

How does your dog react to other dogs? (Generally)

Invalid Input

How does your dog react to strangers?*

Invalid Input

Does your dog have any kinds of people he/ she automatically fear or dislikes?*

Yes

Invalid Input

Please describe

Invalid Input

Has your dog bitten someone?*

Yes

Invalid Input

Please describe

Invalid Input

Has your dog ever been in a fight or bitten another dog?*

Yes

Invalid Input

Please describe

Invalid Input

Is your dog allowed to play outdoors without a leash?*

Yes

Invalid Input

Do you walk your dog?*

Yes

Invalid Input

How often?*

Invalid Input

Distance*

Invalid Input

When you walk your dog, if he/ she sees another dog, does he/she:*

Ignore the other dog

Show some interests but keep walking

Wag his tail in a playful manner and wants to play

Growl and become aggressive

Pull hard on the leash in an attempt to get to the other dog

Invalid Input

When you walk your dog, if he/ she sees a cat or other small animal, does he/ she:*

Ignore the other animal

Show some interests but keep walking

Growl and become aggressive

Pull hard on the leash in an attempt to get to the other animal

Invalid Input

Commands your dog knows

(i.e. come, heel, halt, let's walk, etc...)

Invalid Input