(Note: All dogs must be spayed/neutered by 6 months of age. Proof required. Questions? Please ask.)

(1)

welcome package (V5.June2015)

1 DOG PROFILE.

you.

Owner(s) Name(s): ____________________ Date: _

Street Address: _____________ City:

Province: __________ Postal Code: _ Email: _____________________________________

Home Phone: _ Work Phone: Cell Phone:___________

Is anyone else authorized to pick up your dog? ______________________________________________________

How did you find out about us? ____________________________________________________________________

pooch.

Dog’s Name: _____________ Date of Birth: Sex:

Breed: ________________ Colour: _ Weight: Age: ________

How long have you had your dog? Where did you get your dog? _________

Is your pet spayed or neutered? Yes No (

If no, why not? _____________________________________

)

(Note: All dogs must be spayed/neutered by 6 months of age . Proof required. Questions? Please ask.)

social skills.

Has your dog attended daycare before? __ Yes

__ No

If yes: where? _______________ how often?

Are they still accepted there? How did they do? _______________________

Why do they no longer go there (if applicable)? ________________________________________________

Are there any pets in your home that your dog interacts with? Yes No

If yes, what type of pet(s)? How do they get along?___________

Has your dog ever socialized with a large group of dogs at one time (6 or more)? Yes No

If yes, please explain:

__________________________________________________________________________

Does your dog regularly socialize with other dogs? Yes No

If yes: How often?:

_________________________________

Where? ___________________________________

Is it with familiar or unfamiliar dogs? ____________________________________________________________

Does your dog play friendly with all types of dogs (i.e. different ages, sizes, breeds, etc.)? Yes No

If no, please explain:

___________________________________________________________________________

Does your dog go to off leash dog parks (or similar spaces with unfamiliar dogs)? Yes No

If yes how often?

______________________________________________________________________________

health & wellness.

Vet Clinic Name: Phone:

Veterinarian’s Name: _____ Location/City:

welcome package.

date of social evaluation: _____________________

(2)

2 Does your dog have any physical disabilities, illnesses, or injuries we should be aware of? Yes No

If yes, please explain: ___________________________________________________________________________

Does your dog need medication administered while in our care ? Yes No

If yes, please complete the MEDICATION AUTHORIZATION FORM.

Does your dog have any known allergies or sensitivities (i.e. skin, eyes, etc.)? Yes No

If yes, please explain: __________________________________________________________________________

Is it a relatively normal occurrence for your dog to experience diarrhea or vomiting? Yes No

If yes, please explain: __________________________________________________________________________

Does your dog have a sensitive stomach (i.e. with nervousness, what they eat, etc.)? Yes No

If yes, please explain: __________________________________________________________________________

Do we have your permission to give your dog nutritional treats? Yes No

Does your dog willingly share toys & similar items with other dogs? Yes No

If no, please explain: ___________________________________________________________________________

Is there anything else we need to know about your dog? _____________________________________________

_________________________________________________________________________________________________

* V

ACCINATIONS

–

We require that all dogs be up-to-date on the following vaccinations:

___ D

ISTEMPER

___ R

ABIES

___ P

ARVOVIRUS

__

_ B

ORDETELLA

Pooched! Inc. requires copies of up-to-date vaccination certificates prior to attendance for our records. Dogs must wait a minimum of 72 hours after receiving vaccinations before attending Pooched! Inc. Please advise staff of any recent vaccines administered prior to stay. If you are unsure of your dog’s vaccination history or if you have any questions about the frequency, please consult with your veterinarian. We also accept titer tests paired with written veterinarian approval ensuring the safety of both your dog and others.

* P

ARASITE

P

REVENTION

- Your dog must be current on both a flea & worm prevention program, & be free of parasites

to attend dog daycare or boarding. Please specify which preventative flea & worm program your pet is currently using:

Flea: __ Worm: _

* P

ET

I

NSURANCE

-

Do you have pet insurance? Yes No

If yes, please provide details below: (i.e. Name of Provider,/Company , Policy #, Pet ID #, etc.)

:

___________________________________________________________________________________________________________

* M

ICROCHIP

/T

ATTOO

- Is your dog micro-chipped or tattooed? Yes No

If yes, please specify/provide relevant details below (i.e. Tattoo/Chip #, location, etc.):

______________________________________________________________________________________

training.

Is your dog fully house-trained? Yes No

Is your dog crate-trained? Yes No

If yes, can they have a bed/blanket with them without chewing/destroying/ingesting?

Yes No

Has your dog had any formal training? Yes No

If yes, please describe in detail (& include who it was completed with): ______________________________

______________________________________________________________________________________________

(3)

3 Have you ever trained your dog using a shock collar, e-collar, or similar collars? Yes No

If yes, please explain

: __________________________________________________________________________

Is your dog trained to walk on a leash? Yes No

Describe your dog’s behaviour while on-leash when they encounter other dogs/people:_________________

______________________________________________________________________________________________

Do you have any special commands we should know, specific to your dog? Yes No

If yes, please explain: __________________________________________________________________________

How would you describe your dog’s recall skills? ____________________________________________________

How do you “discipline” your dog when they exhibit unwanted behaviours? ____________________________

How easily are others able to handle your dog? _____________________________________________________

behaviour.

Briefly describe your dog’s overall temperament: ____________________________________________________

How would you best describe your dog’s play-style (i.e. gentle, rough, etc.)? ____________________________

Are there any restrictions that should be placed on your dog’s activities? Yes No

If yes, please explain:

__________________________________________________________________________

Is your dog easily stressed? Yes No

If yes, what are their main triggers & best method of comfort?

______________________________________

Does your dog have any separation anxiety issues? __________________________________________________

Are there any situations your dog is uncomfortable with (types of people, certain dogs or play styles,

objects?) _____________________________________________________________________________________

Has your dog ever destroyed items in your home? Yes No

If yes, please explain: __________________________________________________________________________

Describe your dog’s current nuisance behaviours, if any. Be honest!

(If applicable, check all that apply)

___Excessive Barking

Jumping Digging Climbing Mouthiness __Eating Stool

_Chewing _Other(s):_______________________________________________________________________

When no one is home, where is your dog kept (i.e. free, in a crate)? ____________________________________

Do you have any reason to believe your dog may jump our 5 foot tall fencing? Yes No

Are there any areas on your dog’s body where they do not like to be touched? Yes No

If yes, please explain:

__________________________________________________________________________

Is it easy to take food or other high-value items (i.e. bone) away from your dog freely? Yes No

Is your dog easily able to share toys & balls with other dogs with no issue? Yes No

Has your dog ever bitten or growled at a person or dog (

excluding during friendly play

)? Yes No

If yes, what were the circumstances? _____________________________________________________

Dogs attending Pooched! Inc. for daycare &/or boarding must be friendly, non-reactive, & able to socialize with

all dogs & humans without issue, unless otherwise approved by Pooched! Inc. If your dog won’t do well in a multi-dog environment, Pooched! Inc. may not be an appropriate place for your multi-dog to stay.

(4)

4 EMERGENCY CONTACT FORM

Owner(s) Name(s) _________________________________________________________________________

Dog’s Name: ______________________________________________________________________________

Phone # where you can best be reached: ____________________________________________________

risks.

Your dog’s attendance at Pooched! Inc. is not without risks including: scrapes, cuts, nicks, rashes, diarrhea/soft stool, Bordetella and other contagious viruses. By nature, dogs drool, lick, eat things they shouldn’t, play with their teeth and claws, and from their perspective – just have fun! Despite supervision and preventative measures –things happen. Just like with children.

In case of an illness, injury, emergency or other instance that requires attention while you are away, Pooched! Inc. requests that you have at least two emergency contacts (preferably local) in the event that you cannot be reached. These emergency contacts provided below are authorized to pick up your dog, make decisions on your behalf, and care for them if necessary in your absence. It is your responsibility to inform Pooched! Inc. if this information needs to be updated.



alternate emergency contact #1

Name: _________ Relationship to Owner: _

Phone: ___ Alternate Phone:

City: Province:



alternate emergency contact #2

Name: _________ Relationship to Owner: _

Phone: ___ Alternate Phone:

City: Province:

If

Pooched! Inc.

cannot reach you, or your alternate emergency contact(s), and your dog requires immediate

veterinary attention,

Pooched! Inc

., its agents, or employees, will transport your dog to a veterinarian or to the

Metro Animal Emergency Clinic during after-hours. First and foremost, your dog’s wellbeing takes priority over initial communication.

Pooched! Inc

. will make every effort to have your dog treated by your own veterinarian; however, in the event

your own veterinarian is not available or is too far away,

Pooched! Inc

. will take your dog to a licensed

veterinarian to administer treatments and/or perform procedures that are considered necessary. You will

assume full financial responsibility, and pay

Pooched! Inc.

directly any veterinary fees or charges incurred as a

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5 RULES & POLICIES

1. All dogs are required to undergo a social evaluation on-site at Pooched! Inc. This initial stage of screening is to be done a minimum of 24 hours prior

to intended first stay for both the daycare and boarding service. For daycare (if approved to proceed), dogs are required to attend a trial daycare day (possibly more if further observation is necessary) before being accepted into the regular daycare program. For boarding (if approved to proceed), a trial overnight stay of one (or two) nights are required prior to potential boarding stays (at the discretion of Pooched! Inc.).

2. All dogs must be leashed while on the Pooched! Inc. property, during the entering and exiting of the building, for the safety of your dog and others.

3. Acceptance of a dog into daycare and/or boarding is at the sole discretion of the Pooched! Inc. staff, and may be revoked at any time for any reason,

including unacceptable, inappropriate or aggressive behaviours. Dogs who exhibit such behaviours will be separated from others.

4. Owners must show up at their scheduled drop-off and pick-up times, or risk having to reschedule. Additional charges may also be applied at the

discretion of Pooched! Inc. All up-to-date pricing information can be found on the Pooched! Inc. website at www.pooched.ca . It is the owner’s

responsibility to be aware and/or inquire about such information.

5. All daycare and boarding is pre-booked and by appointment only. All boarding reservations require a non-refundable 50% deposit of the entire

original intended stay in order to secure the reservation –to be put towards the final amount. The remaining amount is to be paid upon pick-up of dog(s), and will include any additional charges due to extra time spent. All dog daycare must be paid in-full at time of pick-up.

6. All boarding reservations require specific dates and times to be given; this is what the deposit and price quote is based on. If arrival occurs after

scheduled drop-off time, charges will remain based on time of scheduled drop-off; unscheduled, early drop-off’s are not permitted.

7. If Pooched! Inc. revokes a dog’s attendance during a stay due to inappropriate or aggressive behaviours, a refund for the remaining amount of time

already paid will be provided (excluding the day the incident occurred, as well as the 50% non-refundable deposit for boarding stays).

8. Spiked collars, choke chains, e-collars, shock collars, and other similar collars are not permitted. All dogs should wear a quick-release collar, preferably

with no tags.

9. All dogs must be spayed or neutered by 6 months of age (documentation required) at the discretion of Pooched! Inc. Female dogs in heat, or

suspected to be in heat, are not permitted.

10. All dogs attending dog daycare and/or boarding are required to be up-to-date on all required vaccinations. All vaccines must be given a minimum of

72 hours prior to arrival. Copies of these vaccination certificates are required prior to attendance (and each year thereafter), unless otherwise recommended in writing by a licensed veterinarian (ensuring the protection of dog and others). Copies will be kept on record at Pooched! Inc. All dogs must also be current on both a flea and worm prevention program, and be free of parasites to attend Pooched! Inc.

11. Please be aware that it is not uncommon for some dogs to have little or no appetite, or an excessive appetite during and after their stay. Some dogs

may also be very lethargic and/or experience mild diarrhea. Pooched! Inc. will monitor such situations closely, and will advise the owners of such occurrences.

12. Dog daycare and boarding is not suitable for all. In the cases where extreme stress or separation anxiety is demonstrated for an extended period of

time, Pooched! Inc. will contact the owner, or the emergency contacts if they are unable to be reached, and have the dog picked up.

13. Pooched! Inc. is not responsible or liable for any lost, stolen or damaged personal property belonging either to the owner or their dog. Dog collars

&/or tags may be removed at any time if deemed necessary by Pooched! Inc. to prevent injury or otherwise. If a dog causes damage to the Pooched!

Inc. facility or equipment, the owner is fully responsible for the full cost of any repair or replacement.

14. If Pooched! Inc. cannot reach owner, or alternate emergency contacts, and the dog requires immediate veterinary attention, they will be transported to

a veterinary hospital, where a licensed veterinarian will administer treatments and/or perform procedures that are considered necessary. Any veterinary

fees or charges incurred will be the full financial responsibility of the owner, who will pay Pooched! Inc. directly upon pick-up.

15. There are inherent and potential risks involved with interactions between humans and dogs, as well between dogs and other dogs, which may result in

property damage or bodily injury, including but not limited to, permanent disability, sickness, or death to human or dog. All owners accept and assume responsibility for all risks including without limitation, all losses, costs and damages incurred as a result of their dog, or their dog’s participation while at Pooched! Inc, including any veterinarian expenses incurred on behalf of their dog.

16. All dogs are required to be in individual suites during rest periods, mealtimes, overnight hours or whenever necessary for their own safety and

well-being at the discretion of Pooched! Inc.

17. It is the sole responsibility of the dog owner to notify Pooched! Inc. of any changes in overall behaviour. This includes any new aggressive, reactive, or

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6 OWNER AGREEMENT

I, _________________________________, hereby certify that my dog, __________________________, is in good health and remains current on all vaccinations and has received a veterinarian exam within the past 12 months. I further certify that my dog has not shown aggressive or threatening behaviour towards any person or any other dog(s). I have read and understand the following:

(PLEASE INITIAL BESIDE EACH)

____ 1. I agree that I have completed the DOG PROFILE FORM and all necessary attachments including the EMERGENCY CONTACT FORM and the MEDICATION AUTHORIZATION FORM (if applicable) on my dog in full, and correctly to the best of my knowledge. I also agree to notify Pooched! Inc. of any changes to the information as required.

____ 2. I agree that I have read and understand the attached RULES AND POLICIES of Pooched! Inc., and agree to be bound by them. I further agree that if I or my dog does not follow the rules and policies, that it is at the discretion of Pooched! Inc. to refuse service to me and my dog.

____ 3. I understand I am solely responsible for any harm or damage caused by my dog to persons or property of the owners, staff, volunteers, and invitees of Pooched! Inc., or any other pet(s) housed or visiting Pooched! Inc.

____ 4. I further understand and agree that Pooched! Inc., and their staff, volunteers, or other agents, will not be held liable for any problems which develop, and I hereby release and discharge them of any and all damages, liability, and/or causes of action of any kind of accident, damage, or injury whatsoever arising from my dog’s attendance in dog daycare and/or boarding.

____ 5. I understand, consent, and agree that any problem or injury that develops with my dog while under the care of Pooched! Inc., will be treated by my own veterinarian. In the event my own vet is not available, or too far away, I agree to leave the choice of veterinarian at the discretion of Pooched! Inc. to treat my dog. I agree to assume full financial responsibility for any and all expenses involved in such treatment.

____ 6. I understand that Pooched! Inc. may take photos and videos of my dog during their stay. These photos and videos may be posted on the company’s website, Facebook, or other marketing materials and outlets. You provide Pooched! Inc. permission to utilize any video or photographs taken of your pet in any future marketing efforts, whether online or in print.

____ 7. This agreement covers the current terms between Pooched! Inc. and yourself, each time you bring your dog to Pooched! Inc., you affirm the terms of this agreement and the truthfulness and accuracy of all statements you have made in this agreement, ____ 8. You agree and understand that it is your responsibility to inform Pooched! Inc. of any changes to the information provided,

including any other relevant information not covered in this form.

____ 9. I authorize Pooched! Inc. to obtain/verify all medical and vaccination records for my dog from the vet listed above and I authorize my vet to provide these records to Pooched! Inc. I also agree to the terms and conditions set forth by Pooched! Inc. regarding the vaccination and parasite prevention requirements to attend, as well as their policy to have my dog spayed or neutered by 6 months of age (unless otherwise discussed).

____ 10. I understand that due to the nature of dog play, and general dog interaction, minor cuts and scratches are not uncommon even with careful supervision. In the event my dog has inflicted serious or fatal injuries on another dog(s), I understand that I am solely responsible (financially and otherwise) for any harm caused by my dog while they are attending Pooched! Inc.

____ 11. I understand and agree that in admitting my dog to Pooched! Inc. that they are relying on my representation that my dog is in good health, and has not seriously harmed, killed, or shown threatening behaviour towards any person or any other dog.

____ 12. Pooched! Inc. takes every reasonable precaution to ensure the safety of your pet; however, in any event, Pooched! Inc.,

its employees, officers, owners, agents or assigns are not responsible for harm, illness, injury or any consequence of damages or harm that may arise there from, however caused and whether or not caused by the negligence of

Pooched! Inc., or any of its employees, officers, agents or assigns, which may happen or be caused to your dog during

its stay.

____ 13. I have initialed each statement above, acknowledging my understanding and acceptance.

I certify that I have read, understood, and agree with the policies of Pooched! Inc., as set forth on the preceding pages, and that I have read, understood, and agree with the conditions and statements of this agreement.

(Note: All dogs must be spayed/neutered by 6 months of age. Proof required. Questions? Please ask.)

1

DOG PROFILE.

you.

Owner(s) Name(s): ______________________________________________ Date: ___________________________

Street Address: _____________________________________________ City: ________________________________

Province: ________________ Postal Code: ___________ Email: _________________________________________

Home Phone: _________________ Work Phone: __________________ Cell Phone:_________________________

Is anyone else authorized to pick up your dog? ______________________________________________________

How did you find out about us? ____________________________________________________________________

pooch.

Dog’s Name: _______________________________ Date of Birth: __________________________ Sex: ________

Breed: ________________________ Colour: _______________ Weight: ______________ Age: ________________

How long have you had your dog? ______________ Where did you get your dog? _______________________

Is your pet spayed or neutered? __ Yes __ No (

If no, why not? _____________________________________

)

(Note: All dogs must be spayed/neutered by 6 months of age . Proof required. Questions? Please ask.)

social skills.

Has your dog attended daycare before? __ Yes

__ No

If yes: where? _________________________________________ how often? __________________________

Are they still accepted there? ____________ How did they do? ___________________________________

Why do they no longer go there (if applicable)? ________________________________________________

Are there any pets in your home that your dog interacts with? __ Yes __ No

If yes, what type of pet(s)? __________________ How do they get along?_____________________________

Has your dog ever socialized with a large group of dogs at one time (6 or more)? __ Yes __ No

If yes, please explain:

__________________________________________________________________________

Does your dog regularly socialize with other dogs? __ Yes __ No

If yes: How often?:

_________________________________

Where? ___________________________________

Is it with familiar or unfamiliar dogs? ____________________________________________________________

Does your dog play friendly with all types of dogs (i.e. different ages, sizes, breeds, etc.)? __ Yes __ No

If no, please explain:

___________________________________________________________________________

Does your dog go to off leash dog parks (or similar spaces with unfamiliar dogs)? __ Yes __ No

If yes how often?

______________________________________________________________________________

health & wellness.

Vet Clinic Name: ____________________________________ Phone: ____________________________________

Veterinarian’s Name: _________________________________ Location/City: ____________________________

welcome package.

2

Does your dog have any physical disabilities, illnesses, or injuries we should be aware of? __ Yes __ No

If yes, please explain: ___________________________________________________________________________

Does your dog need medication administered while in our care ? __ Yes __ No

If yes, please complete the MEDICATION AUTHORIZATION FORM.

Does your dog have any known allergies or sensitivities (i.e. skin, eyes, etc.)? __ Yes __ No

If yes, please explain: __________________________________________________________________________

Is it a relatively normal occurrence for your dog to experience diarrhea or vomiting? __ Yes __ No

If yes, please explain: __________________________________________________________________________

Does your dog have a sensitive stomach (i.e. with nervousness, what they eat, etc.)? __ Yes __ No

If yes, please explain: __________________________________________________________________________

Do we have your permission to give your dog nutritional treats? __ Yes __ No

Does your dog willingly share toys & similar items with other dogs? __ Yes __ No

If no, please explain: ___________________________________________________________________________

Is there anything else we need to know about your dog? _____________________________________________

_________________________________________________________________________________________________

* V

–

We require that all dogs be up-to-date on the following vaccinations:

___ D

___ R

___ P

__

_ B

* P

P

- Your dog must be current on both a flea & worm prevention program, & be free of parasites

to attend dog daycare or boarding. Please specify which preventative flea & worm program your pet is currently using:

Flea: __________________________________ Worm: _________________________________

* P

I

-

Do you have pet insurance? __ Yes __ No

If yes, please provide details below: (i.e. Name of Provider,/Company , Policy #, Pet ID #, etc.)

:

___________________________________________________________________________________________________________

Owner(s) Name(s): ____________________ Date: _

Street Address: _____________ City:

Province: __________ Postal Code: _ Email: _____________________________________

Home Phone: _ Work Phone: Cell Phone:___________

Dog’s Name: _____________ Date of Birth: Sex:

Breed: ________________ Colour: _ Weight: Age: ________

How long have you had your dog? Where did you get your dog? _________

Is your pet spayed or neutered? Yes No (

If yes: where? _______________ how often?

Are they still accepted there? How did they do? _______________________

Are there any pets in your home that your dog interacts with? Yes No

If yes, what type of pet(s)? How do they get along?___________

Has your dog ever socialized with a large group of dogs at one time (6 or more)? Yes No

Does your dog regularly socialize with other dogs? Yes No

Does your dog play friendly with all types of dogs (i.e. different ages, sizes, breeds, etc.)? Yes No

Does your dog go to off leash dog parks (or similar spaces with unfamiliar dogs)? Yes No

Vet Clinic Name: Phone:

Veterinarian’s Name: _____ Location/City:

Does your dog have any physical disabilities, illnesses, or injuries we should be aware of? Yes No

Does your dog need medication administered while in our care ? Yes No

Does your dog have any known allergies or sensitivities (i.e. skin, eyes, etc.)? Yes No

Is it a relatively normal occurrence for your dog to experience diarrhea or vomiting? Yes No

Does your dog have a sensitive stomach (i.e. with nervousness, what they eat, etc.)? Yes No

Do we have your permission to give your dog nutritional treats? Yes No

Does your dog willingly share toys & similar items with other dogs? Yes No

Flea: __ Worm: _

Do you have pet insurance? Yes No

- Is your dog micro-chipped or tattooed? Yes No

Is your dog fully house-trained? Yes No

Is your dog crate-trained? Yes No

Yes No

Has your dog had any formal training? Yes No

Have you ever trained your dog using a shock collar, e-collar, or similar collars? Yes No

Is your dog trained to walk on a leash? Yes No

Do you have any special commands we should know, specific to your dog? Yes No

Are there any restrictions that should be placed on your dog’s activities? Yes No

Is your dog easily stressed? Yes No

Has your dog ever destroyed items in your home? Yes No

Jumping Digging Climbing Mouthiness __Eating Stool

_Chewing _Other(s):_______________________________________________________________________

Do you have any reason to believe your dog may jump our 5 foot tall fencing? Yes No

Are there any areas on your dog’s body where they do not like to be touched? Yes No

Is it easy to take food or other high-value items (i.e. bone) away from your dog freely? Yes No

Is your dog easily able to share toys & balls with other dogs with no issue? Yes No

)? Yes No

Name: _________ Relationship to Owner: _

Phone: ___ Alternate Phone:

City: Province: