Cloud K9

Client Care Form

Please complete this form and bring to your "Meet & Greet" appointment.

 

 

PERSONAL INFORMATION:

 

Dog’s Name: _________________________ Birthdate: ____/____/____  Weight: _____lbs

 

Breed: __________________________Colour: ______________Male: ____ Female: _____

 

Spayed/Neutered? ______   Vet Name: _________________ Phone #: _________________

 

Medication needed during visit: ___________ Amount: _________ Frequency: __________

 

Vaccinations: Bordetella/Kennel Cough: _____  Due: ______ Rabies: _____ Due: _________

 

Parent’s Name: _________________________________Cell Phone #: _________________

 

E-mail Address: _____________________________ Alternate Phone #: ________________

 

Address: ______________________ City: ______________________Postal Code:_________

 

Emergency Contact: _______________________________ Phone #: ___________________

 

 

FEEDING:

 

___________ cups ___________am                          ___________ cups ____________pm

 

Does your dog have a sensitive stomach? _______    Does he/she get human food? _______

 

What are acceptable treats for your dog? ________________    How many / day? __________

 

SOCIAL MEDIA:

 

We would love to post pictures of the fun your pet had with us.  We will not divulge any private information. 

Will you give us permission? ________ (yes/no)  _________________ (Initials)

See www.facebook.com/cloudk9dogcare

 

 

BEHAVIOUR:

 

Will your dog bite/snap if other dogs try to eat his/her food? ________

 

Will your dog share toys with other dogs? ______   Do you walk your dog ON/OFF leash? (circle)

 

Does your dog play and socialize well with other dogs? ________

 

Has he/she ever growled at/bit another person/dog? ______ Circumstances: ______________

 

Has your dog ever been in a dog fight? ______  Circumstances: __________________________

 

What is your dog’s favourite petting spot? ______________ Least favourite spot? ___________

 

Is your dog housebroken? _____  Will he/she come when called? _________________________

 

Has your dog ever jumped over a 5’ fence or escaped repeatedly from an enclosure? _________

 

Are there any restrictions that should be placed on your dog’s activities? ___________________

 

Does your dog let you bathe him/her? ______  Has he/she had fleas? ______ When? ________

 

Has your dog been to a kennel or doggie daycare? ______ Outcome? _____________________

 

What else should we know about your dog? __________________________________________

 

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SERVICES:  (Please check which services apply to your pet)

 

Hiking 2-3 hrs_______  Date_____________  Time __________ - __________

 

Walking 1 hr _______   Date _____________  Time _______ Feed______ Other _______________

 

Visit ½ hr _________    Date _____________  Feed _______ Potty_______ Other ______________

 

Daycare 9 hrs ______   Date ______________ Drop off ____________am     P/U ____________ pm

 

Overnight care ______  Date ______________  Drop off ________________    P/U ______________

 

 

 

AGREEMENTS AND UNDERSTANDINGS:

 

As the guardian of the above referenced dog (s), I understand Cloud K9 will exercise due care to protect the health and safety of my dog (s) while in their care.  In the event my dog becomes ill or sustains injury, I have given permission to Cloud K9 to take the necessary steps to obtain medical treatment for my dog, and I agree to pay all charges incurred.  I consent to any veterinarian being retained to render care for my dog if my vet is not available.

I understand that my dog may be in the presence of other dogs and people, and there may be a chance of injury.  I will not hold Cloud K9 responsible for any injuries to my dog, so long as reasonable care is taken to prevent any unnecessary injury, death or loss of my dog.  I agree not to file legal charges against Cloud K9 and waive and release Cloud K9 from any liability of any nature for any injury, death, or loss resulting from Cloud K9’s actions or from the action of my dog or any other dog in the custody of, or on the grounds surrounding area of Cloud K9 and/or the walking or hiking area.  In the event that my dog is the cause of injury to another dog/pet/person while at Cloud K9, I agree to indemnify Cloud K9 from any action which may be brought against it, and for any defence settlement or judgement against it.  I will assume all liability for the actions of my dog.

I further understand and agree that in admitting my dog to Cloud K9, the owner of Cloud K9 has relied on my representation that my dog is in good health and has not harmed or shown aggression or threatening behaviour toward any person or any other dog.

Cancellation policy is 24 hours notice.  If less than 24 hours notice is given to Cloud K9, they have the authority to charge me half of the booked appointment cost, with a minimum of $10.00.

Above all, I understand it is the responsibility of Cloud K9 to make my dog’s visit an enjoyable and pleasurable time.

 

By signing this form, I _______________________________ (please print) have read, understand, and agree and accept the “Agreements and Understandings” and have accurately completed all information on this form to the best of my knowledge.

 

 

Signature: _________________________________________  Date: ___________________________