SUNNYVALE
Daycare and Slumber Party
Online Application


Red=Required Fields

We appreciate your interest in A DOG'S LIFE Sunnyvale!
What services are you interested in? Daycare
On-site Group Slumber Party
If interested in our On-site Group Slumber Party, please provide specific dates if you have them:
CONTACT INFORMATION
Client Name:
Email:
Address:
City:
State:
Zip:
(REQUIRED: Please list a phone number or more where we can best reach you in any of the selections below)
Home Phone:
Work Phone:
Cell or Pager:
We will only release your dog to a person listed on this form.
(Please list any others who may need to pick up your dog.)
Name:
Phone:
Name:
Phone:
Emergency Contact
(This is a LOCAL person whom we can contact if guardians are out of the area or unable to pick up your dog for any reason)
Name:
Address:
City:
State:
Zip:
Phone:
Vet Contact
Name:
Address:
City:
State:
Zip:
Phone:
DOG PROFILE
Dog's Name:
Breed:
Dog's Birth Date:
Age:
Sex:
Altered:
(All dogs over 6 months old must be altered to be eligible for daycare.)
Length of time you have owned your dog:
Where did you get your dog?
If adopted do you have any knowledge of your dog's past history? (If yes, please list or bring that information with you to the evaluation.)
Any other dogs/pets in your household? # of other pets:
Are they altered?
List other dogs/pets sex and breed:
Briefly describe how your dog gets along with the other dogs/pets in your home:
Vaccination History (please bring copies to evaluation)
DHLPP: (Please indicated date given)
Rabies: (Please indicated date given)
Bordatella: (Please indicated date given)
Medical History and Required Medications:
Special Instructions:
Dietary Allergies:
Is your dog allowed to have treats throughout the day?
Behavior Questions
Does your dog play well with other dogs (not including other household dogs)?
Is your dog scared or aggressive with men?
Is your dog scared or aggressive with women?
Is your dog scared or aggressive with strangers?
Is your dog scared or aggressive toward other animals on walks?
Is your dog scared or aggressive towards people on walks?
Behavior Specifics
Please mark any behaviors your dog displays: Jumping on People
Excessive Chewing
Excessive Barking
Mouthiness
Digging
Escapism
Fence Jumping
General Disobedience
Stool Eating
Pickiness with Food
Housesoiling
Pulling on Leash
Submissive Urination
Shyness with Dogs
Shyness with People
Separation Anxiety
Toy Possessiveness
Food Possessiveness
Water Possessiveness
People Aggression
Dog Aggression
General Questions
Has your dog been to training classes and/or private lessons?
If yes, by whom, when, and for how long?
What commands does your dog know?
Is your dog crate trained?
Has your dog been in daycare before?
If yes, when, for how long, and what was your reason for leaving?
If yes, what were your favorite aspects of your previous daycare?
What things did you dislike most about your previous daycare?
Is there anything else we need to know about your dog?
What is your main daycare goal for your dog?
(e.g., socialization, exercise, don't want your dog home alone all day, etc.)
How did you hear about A DOG'S LIFE?
Referral or other, list here:
Do we have your permission to use photographs of your pet, and/or stories and information about your pet for newspaper articles, websites, flyers and brochures for A DOG'S LIFE?
AGREEMENT
By signing this form, I acknowledge that:
  • My dog will have current DHLPP and Rabies vaccinations at the time of evaluation
  • My dog will have received his Bordatella vaccination prior to the evaluation
  • If I am interested in the On-site Group Slumber Party in A DOG'S LIFE Sunnyvale, I may be asked to bring my dog there more than one time prior to their first date of slumbering to make certain he/she is comfortable there.
  • As the owner of the above listed dog, I hereby give consent for emergency medical care as prescribed by a duly licensed veterinarian. This care may be given under whatever conditions are necessary to preserve life, limb or the well-being of my dog.
Client Name: Date:

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