FORM-New Client Enrollment Client DetailsDog DetailsVet RecordsEmergency ContactsFor the safety of all our guests and to be able to maintain a high level of service, we will try to accommodate last minute requests, however, space may not be available. We require all new canine guests to come in for a Meet & Greet appointment and then two trial days of daycare before an initial reservation can be booked. All vaccination records must be up-to-date and sent over at least 48 hours before the trial day of daycare.I am interested inI am interested in Dog Day Care Overnight LodgingAre you an existing client?Are you an existing client? Yes NoLooking to start services onNumber of Dogs to EnrollNumber of Dogs to Enroll 1 2How did you hear about us?URL SourceHow did you hear about us?How did you hear about us? Referred by Client Dog Park Facebook Rescue Groups Saw Sign Training Class Vet’s Office Web Search *OtherName of ClientName of VetOtherClient Information(1) First Owner(1) First Name(1) Last Name(1) Phone/Mobile(1) Email(2) Second Owner(2) First Name(2) Last Name(2) Phone/Mobile(2) EmailMailing Address:Address Line 1Address Line 2CityState– Select –AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYZip CodeDigital NotificationExamples of notifications that are sent; Vaccination Reminders, Transaction Receipts, After Visit Summary, etc. Enroll in Text Alerts?Enroll in Text Alerts? Yes NoText Notifications are sent as MMS messages. Standard message & data rates apply.Service Provider For: Service Provider For: – Select –AT&TBoostCricketMetro PCSNet10SprintT-MobileTrackPhoneVerizonVergin MobileXfinity*OtherService Provider For: Service Provider For: – Select –AT&TBoostCricketMetro PCSNet10SprintT-MobileTrackPhoneVerizonVergin MobileXfinity*OtherSave & ResumePreviousNextDog InformationDogs NameGender– Select –MaleFemaleSpayed/Neutered?– Select –YesNoNo, Under six months of ageBreedColorWeight (lbs)Birthday (or best guess) *DOB-Month-Select Month –JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDOB-Day-Select Day –12345678910111213141516171819202122232425262728293031DOB-YearHealth HistoryDoes your pet have any health issues?Does your pet have any health issues? Yes NoIs your pet currently on a flea preventative?Is your pet currently on a flea preventative? Yes NoHas your pet ever had a seizure?Has your pet ever had a seizure? Yes NoDoes your pet have any allergies?Does your pet have any allergies? Yes NoIs your pet taking any medications or supplements?Is your pet taking any medications or supplements? Yes NoMedications/SupplementsHas your pet had an Adverse Reaction to Flea/Tick Protection?Has your pet had an Adverse Reaction to Flea/Tick Protection? Yes NoHas your pet had an Adverse Reaction to Any Vaccinations?Has your pet had an Adverse Reaction to Any Vaccinations? Yes NoFlea & Tick Prevention Message: While it is not required, it is HIGHLY recommended that ALL dogs be given a flea and tick preventative as they will be in close contact with other dogs. We recommend discussing this with your veterinarian office.Health Detail InformationYou indicated you dog has either had a seizure or an adverse reaction, please provide details.Socialization InformationDoes your pet have issues with…Does your pet have issues with… Separation Anxiety Toy Aggression Food Aggression Leash Aggression Barrier Aggression People Cats Dogs Sensitivity When Touching Collar No IssuesWhere does your pet socialize with other pets?Where does your pet socialize with other pets? Dog Park Dog Daycare Street, leash only Home Isn’t SocializedIs your pet aggressive toward…Is your pet aggressive toward… Adults Children Cats Dogs No known aggressionHas your pet been to daycare before?Has your pet been to daycare before? Yes NoPrevious DaycareReason for facility change:Has your pet ever bitten…Has your pet ever bitten… Adult Child Another Animal NoDetails / ExplainHas your pet jumped a fence/barrier?Has your pet jumped a fence/barrier? Yes NoSpecify Circumstances & Height JumpedAre there any behavioral concerns?Are there any behavioral concerns? Yes NoPlease tell us anything else that will help us care for your pet:Are you Enrolling a Second Dog?Are you Enrolling a Second Dog? Yes NoSecond Dog InformationDogs NameGender– Select –MaleFemaleSpayed/Neutered?– Select –YesNoNo, Under six months of ageBreedColorWeight (lbs)Birthday (or best guess) *DOB-Month– Select Month –JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDOB-Day-Select Day –12345678910111213141516171819202122232425262728293031DOB-YearHealth HistorySome description about this sectionDoes your pet have any health issues?Does your pet have any health issues? Yes NoIs your pet currently on a flea preventative?Is your pet currently on a flea preventative? Yes NoHas your pet ever had a seizure?Has your pet ever had a seizure? Yes NoDoes your pet have any allergies?Does your pet have any allergies? Yes NoIs your pet taking any medications or supplements?Is your pet taking any medications or supplements? Yes NoMedications/SupplementsHas your pet had an Adverse Reaction to Flea/Tick Protection?Has your pet had an Adverse Reaction to Flea/Tick Protection? Yes NoHas your pet had an Adverse Reaction to Any Vaccinations?Has your pet had an Adverse Reaction to Any Vaccinations? Yes NoFlea & Tick Prevention Message: While it is not required, it is HIGHLY recommended that ALL dogs be given a flea and tick preventative as they will be in close contact with other dogs. We recommend discussing this with your veterinarian office.Health Detail InformationYou indicated you dog has either had a seizure or an adverse reaction, please provide details.Socialization InformationDoes your pet have issues with…Does your pet have issues with… Separation Anxiety Toy Aggression Food Aggression Leash Aggression Barrier Aggression People Cats Dogs Sensitivity When Touching Collar No IssuesWhere does your pet socialize with other pets?Where does your pet socialize with other pets? Dog Park Dog Daycare Street, leash only Home Isn’t SocializedIs your pet aggressive toward…Is your pet aggressive toward… Adults Children Cats Dogs No known aggressionHas your pet been to daycare before?Has your pet been to daycare before? Yes NoPrevious DaycareReason for facility change:Has your pet ever bitten…Has your pet ever bitten… Adult Child Another Animal NoDetails / ExplainHas your pet jumped a fence/barrier?Has your pet jumped a fence/barrier? Yes NoSpecify Circumstances & Height JumpedAre there any behavioral concerns?Are there any behavioral concerns? Yes NoPlease tell us anything else that will help us care for your pet:PreviousNextVeterinarian Contact InformationName of ClinicClinic Phone NumberVaccination RecordsDo you have a Picture / File of vaccination records?Do you have a Picture / File of vaccination records? Yes NoMethod of submitting reccords:Method of submitting reccords: File Upload Send via EmailUpload a scanned document or picture of vaccination records belowPlease obtain a copy and send us a copy, or have your veterinarian office send us a copy.Email: Info@HappyHoundsDayCare.comEmail: Info@HappyHoundsDayCare.com‘s RecordsFile UploadChoose File ‘s RecordsFile UploadChoose File PreviousNextEmergency ContactsIn the event of an emergency, our initial contact will be with you. If we are unable to reach you, we will then get in touch with the designated emergency contacts. These contacts should be individuals other than yourself or your partner, and they should be capable of caring for your pup(s) either when we cannot reach you or when you are away. A minimum of one emergency contact is REQUIRED!Contact 1 NameContact 1 PhoneContact 2 NameContact 2 PhoneContact 3 NameContact 3 PhoneI have read and understand the requirements for enrollment, and the information entered is accurate to the best of my knowledge.PreviousSubmit Enrollment
