STEP 2: Complete Our Canine Application Form

CANINE APPLICATION FORM

At Gus's Day Diggs we require the Canine Application Form filled out and provided to us prior to your dog joining our daycare. Please complete the require fields below and continue filling out our Owner Agreement Form, and Veterinary / Medical Agreement.

1. Your Contact Information

Your Name (required)

Your Email (required)

Your Phone # (required)

Alternate Phone #

Your Address (required)

How Did you Hear About Us? (required)

2. Emergency Contact Information

Contact Name (required)

Contact Phone # (required)

3. Alternate Pickup Person

Contact Name

Contact Phone #

Relationship To You

4. Booking Date & Time

Drop-off Date

Drop-Off Time

Pickup Date

Pick up Time

5. Dog Information

Dog Name (required)

Dog Nickname

Date Of Birth (required)

Breed (required)

Weight (lbs) (required)

Color (required)

Gender (required)

Spayed / Neutered (required)

Micro Chip / Tattoo

License Number (required)

6. Dog Background (All Required)

YesNo Are We Feeding Your Dog?

YesNo Do You Allow Treats?

YesNo Does Your Dog Share Treats Well?

YesNo Does Your Dog Share Toys Well?

YesNo Does He Know His/Her Name?

YesNo Is Your Dog House Trained?

YesNo Does Your Dog Jump On People?

YesNo Does Your Dog Jump Over Fences / Prone To Escaping?

YesNo Does Your Dog Bark Excessively?

YesNo Has Your Dog Been Involved In A Fight?

YesNo Does Your Dog Get Along / Plays With Other Dogs?

YesNo Does Your Dog Get Along With Puppies?

YesNo Does Your Dog Get Along With Children?

YesNo Does Your Dog Get Along With Strangers?

YesNo Is Your Dog Shy Towards Others?

YesNo Does Your Dog Have Any Fears Or Phobias?

YesNo Does Your Dog Have Any Sensitive Areas?

YesNo Does Your Dog Have Destructive Behavior

YesNo Is Your Dog a High Energy Dog?

YesNo Does Your Dog Pull Excessively?

7. Dog Health Information (All Required)

YesNo Does Your Dog Have Any Allergies?

YesNo Does Your Dog Have Any Medical Conditions?

YesNo Is Your Dog On Medication?

YesNo Has Your Dog Had Flea/Tick Prevention?

YesNo Has Your Dog Had Heart Worm Prevention?

YesNo Does Your Dog Have Any Physical/Medical Restrictions?

RabiesBordatella (Kell Cough)DistemperParvovirusParafinfluenzeHepatitis Check The Immunizations Your Dog Has Gotten

Any Special Instructions

8. Release Waiver

You Must Agree To The Release Waiver

I certify that I am the agent of this pet. I hereby grant this establishment, Gus’s Day Diggs Inc. to act in my behalf, and in my pets best interest, by obtaining veterinary care at my expense, if deemed necessary for all illness, injury or death. I further agree to pay all other services incurred by and for my pet during its stay at this facility. This includes any injury or damage to a person, place, object or animal. Gus’s Day Diggs Inc. agrees to exercise all due and responsible care to prevent injury, illness, death and damage to and from my pet; however, in the event of illness, death or damage Gus’s Day Diggs Inc. its owners, successors, directors, staff, agents or volunteers shall not be held liable. I agree that all daycare fees must be paid in full on the day of pickup of my pet, and I understand my pet may not leave the premises until all charges are paid for in full.

Please note that a signature will be required at time of drop-off. We will print this filled out form out for you at that time.