New Dog Information Form

If you have more than one dog in your family, please fill out all fields for the first dog, and fill out a new form for each additional dog. You ONLY need to fill out fields marked with (*) for the additional dog(s).


How did you hear about us?


If you chose "friend" or "vet referral" please tell us who...



*Your first name



*Your last name



*Home Phone (or cell if it is the same)



Cell Phone



Work Phone



If an emergency were to occur, we would contact you first. But if you are traveling out of town or you cannot be immediately reached, please provide us with an....
EMERGENCY CONTACT NAME


...and that person's EMERGENCY CONTACT PHONE NUMBER



Which phone would you prefer us to call FIRST to reach you?
HOME
CELL
EMERGENCY
WORK



Street Address


Zip code



*Email Address (for receipts/confirmations only- No spam)



*Dog's Name



*Dog's Sex
MALE
FEMALE



*Is your dog spayed/neutered?
YES
NO



*Breed of Dog



*Dog's Color/Markings



*Dog's age or Birth Date



*Is your dog used to being around/playing with other dogs?
YES
NO



*Does you dog have any allergies?
YES
NO


If you answered "yes," what is your dog allergic to, and what is the allergic reaction? Please explain...



*Does you dog regularly take medication?
YES
NO


If you answered "yes," what medications and why? Please explain...



*Has your dog ever had a seizure?
YES
NO


If you answered "yes," do the seizures occur regularly or are they controlled by medication? Please explain...



*Is your dog fearful of certain noises or people?
YES
NO


If you answered "yes," please explain. ie: thunder, the vacuum, people wearing hats, etc...



*Has your dog ever snapped at or bit another dog?
YES
NO


If you answered "yes," please explain. ie: only on-leash, when he/she is started, whenever he/she sees other dogs, etc...



*Has your dog ever escaped from your home of another dog facility?
YES
NO


If you answered "yes," how did/does your dog escape? And can your dog jump a 6 foot or an 8.5 foot fence? Please explain...



*Have you already called and made a boarding reservation or a daycare appointment?
YES
NO



Please use the field below if there is there anything else you would like to tell us about your dog's personality or history...






Please read the Pet Play House Inc. rules below....



This is a Contract between “Pet Play House, Inc.” and the pet owner whose agreement appears below. Hereinafter, pet owner is called “Owner,” and pet owner’s pet(s) is called “dog(s)”

1) Owner understands that dog(s) must be in good health. Owner certifies that dog(s) is in good health and has not been ill in the last 30 days. On admission, owner certifies that dog(s) must be free from any condition which could potentially jeopardize other clients. If dog(s) has been ill with a communicable condition within the last 30 days owner must submit veterinarian certification of health prior to being admitted or re-admitted.

2) Owner understands that if dog(s) is to participate in group play, dog(s) must behave in a non-aggressive way toward other dogs, and not be toy or space protective. Owner certifies that dog(s) has not harmed or shown any aggressive or threatening behavior toward any person or dog if dog(s) is to participate in group play. Owner understands that if dog(s) exhibits aggressive behavior, owner will be notified and dog(s) will be removed from group play at the discretion of Pet Play House. Additional fees may apply if dog(s) is boarding.

3) Owner understands that he/ she is solely responsible for any harm caused by his/her dog(s) while dog(s) is in attendance at Pet Play House daycare and/or boarding. Owner further understands and agrees that in admitting dog(s), Pet Play House has relied on Owner’s representation that dog(s) is in good health and has not harmed or shown aggression or threatening behavior toward any person.

4) Owner understands and agrees that Pet Play House and it’s staff will not be liable for any problems that develop provided reasonable care and precautions are followed, and owner hereby releases Pet Play House of any liability of any kind whatsoever arising from dog(s) attendance at Pet Play House. Owner further understands and agrees that any problem that develops with dog(s) will be treated as deemed best by the staff of Pet Play House, in their sole discretion, and that Owner assumes full financial responsibility for any and all expenses involved.

5) Owner permits Pet Play House to obtain treatment from a licensed veterinarian for dog(s) should it become necessary in Owner’s absence. The veterinarian is authorized to perform any treatment he/she deems necessary, including hospitalization. Owner understands that every effort will be made to contact them in such an event. Owner agrees to pay for any expenses incurred.

6) Owner understands all fees are due and payable in advance of service. Cash, checks, Visa, and Master Card are accepted. $20.00 charge for all returned checks.

7) Owner understands that all boarding deposits become non-refundable 10 days prior to the drop-off date. A 50% deposit is required to hold all boarding reservations. Owner further understands that weekly daycare packages are to apply only to the week in use.

8) Owner agrees to pick up and drop off dog(s) ONLY during Pet Play House’s business hours. . If dog(s) is not picked up by closing time, dog(s) will spend the night – dog(s) will be fed “dog food du jour” and owner will be charged boarding and feeding fees. Owner agrees to drop off dog(s) before 12:00 noon if dog(s) is to participate in group-play daycare or slumber party boarding.




Clicking "I Agree" indicates that you have read and agree to abide by all the rules, terms, and conditions set fourth above - This will send your information to us automatically.