Dog Daycare Enrollment Form printable pdf download

Dog Daycare Enrollment Form

Dog Daycare

Enrollment Form

Dog’s Name:

23960 Dixie Hwy., Suite B, Perrysburg, OH 43551

Client’s Information

• 419-872-0087

419-872-0088

(PH)

(FAX)

Name:

Date:

Address:

Home Phone:

Work Phone:

Cell Phone:

Can you receive text messages?

Y / N

Email:

Emergency contact if you cannot be reached:

Phone:

How did you hear about us?

If referred by a current client, we would like to thank them with one free day of daycare.

Pet Medical & Veterinary Information

Veterinary / Clinic Name:

Phone:

Veterinarian Name:

Fax:

Veterinarian Address:

List medical issues current or past you are aware of:

Is your dog currently on any medication?

Y / N

Name of medication and purpose:

Known allergies:

Does your dog have any medical restrictions on his/her activities?

Y / N

Explain:

Neutered/Spayed?

Y / N

Date:

Dogs 6 months of age+ must be neutered/spayed.

Bordetella Date:

Distemper Date:

Rabies Vaccine Date:

Flea/Tick Product:

Date:

All daycare participants and overnight stays are required to be current on all vaccines. Please

provide proof of vaccinations. Your vet can fax us your records at 419-872-0087.

Dog Daycare Enrollment Form

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