welcome package. 3190 sackville drive, upper sackville, ns date of social evaluation: 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 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 (V5.June2015) 1
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 If yes, please complete the MEDICATION AUTHORIZATION FORM. 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 If no, please explain: Is there anything else we need to know about your dog? * VACCINATIONS We require that all dogs be up-to-date on the following vaccinations: DISTEMPER RABIES PARVOVIRUS BORDETELLA 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. * PARASITE PREVENTION - 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: * PET INSURANCE - Do you have pet insurance? Yes No If yes, please provide details below: (i.e. Name of Provider,/Company, Policy #, Pet ID #, etc.): * MICROCHIP/TATTOO - 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): welcome package (V5.June2015) 2
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 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 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 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 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 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 multidog environment, Pooched! Inc. may not be an appropriate place for your dog to stay. welcome package (V5.June2015) 3
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 result of Pooched! Inc. exercising this authority. Pooched! Inc. is not required by law to provide medical aid. welcome package (V5.June2015) 4
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 wellbeing 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 inappropriate behaviour with other dogs or humans. welcome package (V5.June2015) 5
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. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 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. 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. 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. 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. 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. 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. 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, 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. 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). 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. 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. 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. 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. Signature of Owner: Owner s Name Printed: Date: welcome package (V5.June2015) 6