MRAH - Doggie Daycare Application MRAH Logo
Doggie Daycare Application


    DOGGIE PLAY CARE APPLICATION

     

     

     
    Home Phone Number *
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    Email *

    Dog's Information (all dogs must be 16 weeks of age or older)

      Age when spayed or neutered? *
    All dogs must be spayed or neutered by 6 months of age

    Where did you obtain your dog from? *

     
     
    Provide explanation in this box *


     
    How does your dog react when strangers approach your home, yard or out in public? *

     
    How does your dog react to puppies? *

     
     
     
    Provide explanation in this box. *

     
    Does your dog have any physical problems or disabilities which may affect them in play Care? If yes, please explain. *

     

     
    How much exercise is your dog currently getting? *

     
    What is the main reason you have chosen play care for your dog? *

    HEALTH & TEMPERAMENT AGREEMENT

    We require a copy of your dog's vaccine history and intestinal parasite testing.
    Requirements include:  Current Rabies Vaccine, Current Distemper Combo Vaccine (DHPP), Bordatella (KC), on flea prevention & negative intestinal parasite test within the last year.
    Please list any allergies your dog has. *
    Has your dog had ticks or fleas in the last year? If yes, please explain *
    What heartworm prevention is your dog receiving and when was last dose given? *
    What flea and tick prevention is your dog receiving and when was the last dose given? *
    Please provide us with your Veterinarian's name and phone number. *

     

    EMERGENCY CARE PERMISSION

    I/We give Murphy Road Animal Hospital permission to give our dogs care / treatment in case of any emergency.  I/We will be solely responsible for all payments, in full, incurred at this facility.  I/We also understand and agree that severe emergencies may require treatment before we are contacted.

    Rough Housing
    There is inherent rough housing in dog play.  All dogs are screened for aggression, but altercations can still occur.  It is also possible for a puncture wound to happen during play sessions.  In the event of a fight or injury, if needed, you will be contacted.  We always attempt to contact the owner or emergency person before providing any medical attention.
    ALTERNATE EMERGENCY CONTACT INFORMATION

     
    Alternate Emergency Contact Phone Number
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    Additional Contact Phone Number
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