Registration Form

DOG DAY CARE

Day Care registration Form

Client Details

Full Name

Landline Number

Mobile Number

Address

Address Line 1

Address Line 2

Town

Postcode

Contact Details (Person 2)

This person must be available to collect your dog/s if needed

Full Name

Phone

Emergency Contact

For boarding/daycare (this person must be contactable if the first 2 numbers are not)

Full Name

Phone

Vet Details

Name of Practice

Number of Practice

Practice Address

Address Line 1

Address Line 2

Town

Postcode

Dog Questionnaire

Name Of Dog

Breed Of Dog

Dogs Date Of Birth

Gender Of Dog

Male

Female

Has Your Dog Been Spayed / Neutered?

Yes

Date of Spay / Neuter?

When was your dog last vaccinated?

Upload Vaccination Record

Choose File

Has your dog been vaccinated against kennel cough?

Microchip details (Database & Number

What Flea & Worming treatment do you use?  

Is your dog insured?

If YES please provide the insurers details, including policy name and number.

Are they allowed to be given treats at the centre?

Yes

Date adopted?

What do you know of their history ? (If known)

Please list any current health problems; joint issues, long term conditions or concerns you may have with your dog (any fatty lumps? History of fits?): PLEASE LIST ANY/EVERYTHING NO MATTER HOW MINOR

Is your dog on any medication, restricted exercise or is having at home vet care? If so please list medications or additional instructions for care:

What kinds of activities does your dog like to do? (E.g. playing fetch, Frisbee, balls, chew toys, swimming)

What brand/type of food does your dog eat?

How many times a day do you feed your dog? Please state the amount given at each feed

Is your dog a rescue dog?

Yes

Does your dog have food allergies or any snacks or foods he/she is NOT allowed to have? (E.g. Pig ears, raw hides, gluten etc.)

How often do you walk your dog and for how long?  Please state number of days and minutes for walk.

Is your dog crate trained?

Yes

My dog is good off leash and has good recall

Yes

Have you ever boarded your dog before?

Yes

Duration of stay if yes

Is your dog happy around children of all ages?

Yes

Please give more details:

How does your dog behave around cats?

Has your dog ever bitten another dog or human? PLEASE BE HONEST!!! (This is to protect your dog and ensure they will not be put in a similar situation where they may bite. E.g. Scared of the hoover which caused them to bite.)

My dog is well behaved around:

My dog:

How does your dog react to strangers entering the home or passing by?

Please declare any behavioural issues that your dog has/may have. (E.g. Food/lead aggression, separation anxiety, noise-phobic, sock eating, fear of hoover, food/toy possession etc.) 

When my dog barks or growls it could mean:

When my dog whines or cries it could mean:

When my dog wants outside to go to the bathroom he/she will:

Answer only if you have more than one dog being boarded:

My dogs will need to be fed separately:

Yes

My dogs will need to be crated separately:

Yes

Has your dog had any form of formal training? Is so, when and where?

What commands does your dog(s) respond too? (stay, off, sit, down, etc.)

If there is anything else you could tell us about your dog please use the space below. Please also include your dog’s daily routine and schedule (Wake up time, feeding time, toilet times, walk times, habits.)

Owner Agreement

I hereby certify that my dog(s):

Is/are in good health and has/have not been ill with any transmittable condition in the last 48 hours. I further certify that my dog(s) has/have not harmed, shown aggression or threatening behaviour towards any person. I have also submitted any details regarding aggressive behaviour towards other dogs that my dog(s) has/have shown. I have read and understand the following:

I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are attending A Groom With A View Day Care.

I further understand and agree that in admitting my dog(s) to a Groom With A View Day Care, the staff members are relying on my representation of my dog’s health and behaviour towards people and other dogs.
I understand and agree that A Groom With A View Day Care and their staff, will not be liable for any problems that develop, providing reasonable care and precautions are followed. I hereby release them of any liability of any kind arising from my dog(s) attendance and participation at the Day Care.
I further understand and agree that dogs can sometimes receive minor cuts and scratches at day care and any problems that arise with my dog(s) will be treated as deemed best by staff of A Groom With A View Day Care, at their sole discretion. I assume full financial responsibility for any and all expenses involved.
I give my consent that, if needed, I allow A Groom With A View staff to walk my dog(s) out of the premises on lead.
I understand that A Groom With A View use Collingham Vets as their Vets practice, and that my dog(s) may be taken here for treatment or advice if needed.
I understand that A Groom With A View have a 3 strike policy on disruptive behaviour, if intervention via distraction techniques fails, after 3 strikes my dog(s) will be excluded from attending.
I give permission for A Groom With A View Day Care to administer my dog’s medication and to feed as required and instructed by owner.

9. I give permission for A Groom With A View Day Care to use my email address and personal information to contact me and to use as deemed necessary. Please tick appropriate box:

I Agree

I Disagree

11. I also give permission for A Groom With A View Day Care to take and use photos of my dog whilst in our care including the use on social media. Please tick appropriate box:

I Agree

I Disagree

10. I also confirm I have read and fully understood the information presented in the ‘Dog Day Care General Information and Policies’ (Please see pages 2 & 3). Please tick appropriate box:

I Agree

I Disagree

11. Bitches who come into season must be collected at the earliest convenience from both daycare and boarding. We cannot be held responsible for any incidents that occur should a bitch be in season whilst in our care. It is the owners responsibility to inform the staff of any behavioural or bodily changes that indicate a season may be starting

I Agree

I Disagree

12. I give permission for our dog, even if multiple from the same family are able to mix together and sleep in the same area unless I as the owner give written instructions for my dog to be kept separate at certain times

I Agree

I Disagree

I certify that I have read and understand the policies of A Groom With A View Day Care as set forth on the preceding pages and that I have read and understood the conditions and statements of this agreement.

Signature

Sign Here

Print Full Name & Date

Contact Us

01522 690437

Email Us

A Groom With A View Old Wood Lincoln LN6 5UA

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Working Hours

Grooming Salon

Mon - Fri 8:00am - 5:00pm
Saturday - 10:00am - 4:00pm
Sun - CLOSED

Doggy Daycare

Mon - Fri 7:30am - 5:30pm
Saturday - 10:00am - 4:00pm
Sundays & Bank holidays - CLOSED

Home boarding pickup and drop offs 10am-2pm (by prior appointment only)

Send Us A Message

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Phone/Mobile

Grooming Service Required

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