We provide dog training, behavior consulting, dog sport, daycare and in home boarding services. Our staff are certified or working under the supervision of certified trainer.
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Doggy Daycare Form for New Clients
Please read and agree to the attached Waiver, Informed Consent and Policies document (click here):
Current - CCinc Waiver Sep 2023.docx
You and Your Pet:
Please provide the following information to help use serve you better.
Name
*
Email
*
Address
*
-- Country --
Australia
Canada
United Kingdom
USA
Phone
*
-- Country Code --
+1 - Canada
+1 - USA
+61 - Australia
+44 - United Kingdom
Other Phone
How did you hear about us?
*
Drive By
Facebook
Other Social Media
Google
Other Search Engine
Family/Friend/Neighbor
Groomer
Newsletter
Rescue Group
Other Courteous Canine Inc. Clients
Rescue Group
Veterinarian
Other
Pet Name
*
Breed
*
Birthday
*
Weight
*
Sex
*
-- Select One --
Male
Female
Spayed or Neutered
*
Yes
No
Unknown
Age when Spayed or Neutered?
Pediatric
6 months
Adult
Unknown
In addition to you, list the names and ages of all people and animals in the household, including yourself:
*
Has your dog ever bitten a person?
*
Yes
No
Has your dog ever bitten another dog?
*
Yes
No
Does your dog have any behavior issues such as aggression, reactivity, etc?
*
Yes
No
Has your dog ever attended another daycare?
*
Yes
No
Can your dog handle being touched on the head, neck, shoulders, etc.?
*
Yes
No
Is your dog ok with collar grabs and other handling?
*
Yes
No
Does your dog crate well without vocalizing or signs of distress?
*
Yes
No
What is your dog's play style (rough, relaxed, energetic, etc)?
*
What is your dog's energy level?
*
High energy
Medium energy
Low energy
Does your dog play well with small dogs or big dogs or both?
*
Small Dogs
Big Dogs
Both
What kind of treats can your dog have?
*
Courteous Canine treat, i.e. Cheerios
Treat supplied by parent only
Other
Other
Does your dog have any medical concerns or allergies? If so, please describe.*
*
Is your dog microchipped?
*
Yes
No
Unknown
People Authorized to Pick Up Your Pet:
*
Emergency Contact Name:
*
Emergency Contact Phone:
*
Medication Schedule/Notes:
Feeding Schedule/Notes:
Other notes:
Veterinarian used:
*
By selecting the field below I agree to provide up to date shot records for my dog prior to my first appointment by emailing shot records to LoveDogs@CourteousCanine.com
*
-- Select One --
I agree to email my dog's shot records to LoveDogs@CourteousCanine.com
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