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 Jun 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
Would you like your email added to our newsletter list?
*
-- Select One --
Yes
No
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
Is your dog microchipped?
*
Yes
No
Unknown
Veterinarian used:
*
Does your dog have any medical concerns or allergies? If so, please describe.*
*
People Authorized to Pick Up Your Pet:
*
Emergency Contact Name:
*
Emergency Contact Phone:
*
Medication Schedule/Notes:
Feeding Schedule/Notes:
Other notes:
Does your dog crate well without vocalizing or signs of distress?
*
Yes
No
Is your dog ok with collar grabs and other handling?
*
Yes
No
VACCINE INFO: DHLPP
*
Expiry Date
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Bordetella - Expiry Date:
*
Canine Influenza - Expiry Date:
Leptospirosis - Expiry Date:
Rabies - Expiry date:
I have read and agree to the terms above
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