Print packet out and bring with you.....(if you cant print it out I do have copies available I can give you at our meet -n- greet)

(*full payment by either cash or check is expected on drop off date)

Danni’s Darling Dawgs Daycare and Boarding 
1.)Owner’s name___________________________

2.)Address________________________________

3.)Telephone #_____________________________

4.Email___________________________________

Incase of emergency contact: (if I cannot be reached the following person(s) has the authority to pick up or authorize care for my pet, including but not limited to medical care)

Name____________________________________

Telephone #_______________________________

 
Vet information

Name of vet__________________________________

Address_____________________________________

Telephone #__________________________________

Pet info

1.)Pet’s name________________ 2.)Breed________________________

3.)Sex______________________ 4.)Microchip Id__________________

5.)Identifying traits or tattoos____________________________________

6.)Age___________

Medical info

1.)Is your pet spayed or neutered?_____________

2.)Known allergies_____________________________________________

3.)date rabies vaccination________________________________

4.)Medications and instructions for each:

___________________________________

___________________________________
Care Instructions

1.) Treats allowed          YES                 NO

2.)Canned food brand___________________ amount_____________ Frequency___________

3.)dry food brand________________ amount __________ frequency ________

4.)Bathroom command______________________________________________

5.)Tips for making my pet feel loved and comfortable____________________

__________________________________________________________________

6.)Other special instructions___________________________________________

___________________________________________________________________


Behavior 1.)Does your dog have any behavior issues?________________________________________________________________________________

_____________________________________________________________________________________

 

2.)Has your dog ever bitten someone?_____________________________________________________________________________

_____________________________________________________________________________________

3.)Does your dog have any fears or dislikes?______________________________________________________________________________

_____________________________________________________________________________________

4.)Commands your pet knows _____________________________________________________________

Permission for:

1.) To use photo’s taken of your pet during daycare or boarding for advertising?   YES        NO

2.)To transport your pet for a trip to the park or any other dog related activity ?    YES        NO

3.)To provide transportation and authorized medical care for your pet in lieu of your absence?
  YES      No
 (signature required)________________________________________________

4.)  Could I give your name or email to future clients as a reference?    YES       NO
"Hold harmless" Agreement and & liability release for Danyell Secore's Doggy Daycare.

Responsibility & liability:

I feel confident that Danyell Secore and family makes every effort to provide a clean, safe and open environment for pets left in her care. I agree to leave my pet for daycare, boarding at my own risk. I have researched the environment and agree with "open play" and "outside exercise" that would be provided. I understand all dogs do bite and am aware of the risk of injury to my pet & that I am responsible for any injury, physical or financial damage caused by pet to another pet, person or facility .I will not hold Danyell Secore and family responsible, If an accident, injury ,illness death or loss of my pet occur while in her care.


SIGNATURE______________________________________________________ DATE_______________________


Medical treatment

In my absence, I give permission for Danyell Secore and family to act on my behalf in case of an emergency or apparent health related issue. I also give permission for my pet to be transported by car to (1) my personal veterinarian or (2) an emergency animal clinic for any situation that medical assistance is needed while in the care of Danyell Secore and family. I will not seek retribution from Danyell Secore and family should an accidenl , injury, illness , death or loss of my pet occur during or following any services rendered by Danyell Secore and family.

Vaccinations/overall health

I hereby declare my pet is current with all recommended immunizations appropriate for the pet.

Signature_____________________________________  Date_________

Witness Date
 
My Promise to you

I promise to care for your pet with kindness , responsibility and compassion.

Danyell Secore

(optional info)

EMERGENCY VETERINARY CARE

AUTHORIZATION & RELEASE

In the event any pet of mine becomes ill or injured while in the care of Danyell Secore and family I hereby authorize her or Erick Yip to transport the pet to the

following veterinarian to diagnose and treat its condition:

HOSPITAL/CLINIC:

DOCTOR NAME:

ADDRESS:

PHONE NUMBER(S)

EMERGENCY CONTACT:

In the event the above veterinarian is not available, I authorize the Service at its discretion to

obtain veterinary care from another veterinarian in the same clinic, or a different veterinarian /

veterinary clinic, or an emergency care clinic, as it deems appropriate.

I understand that all efforts will be made to contact me regarding my pet’s condition, diagnoses

and suggested treatment. However, if it is not possible to contact me, I authorize the

veterinarian or emergency care clinic to diagnose and treat my pet at his/her discretion, [if

applicable: to a maximum treatment limit of $_________ per pet]. I further authorize my pet’s

veterinarian to provide access to medical records for my pet(s) to any additional veterinarian(s)

or clinics who are involved in providing treatment or care to my pet(s).

I understand that I am solely responsible for the payment of and/or reimbursement to the

Service for any and all veterinary services rendered, including but not limited to diagnosis,

treatment, medical supplies, kenneling, and special diet. I agree to pay all such costs within

______ days of receiving notice of same. I further agree to pay the Service’s charges for

emergency transportation, supervision and emergency care giving within ___ days of being

invoiced for the same.

In the event that the veterinarian requires immediate payment, it may be charged to my credit

card below:

Credit Card Type:

Name on Card:

Credit Card Number:

Expiry Date: