Check-in Form

Gracious Kennels Ranch and Spa

 

Dogs Name: ____________________________________________________________

Owner’s Name: _________________________________________________________

Owner’s Address: _______________________________________________________

City: ___________________________   State: ______________  Zip: ___________

Home Phone: _______________   Alt:_______________________

Emergency Contact: ________________________ Phone: _________________

Proof of vaccinations and a current fecal exam within the last 3 months, is required prior to or at the time of boarding. In order to provide better protection for your pet, all vaccinations should be given at least 1 to 2 weeks prior to boarding.

DHLP: ____________________________   Parvo: _____________________________

Bordetella (within 1 year): ________________________________________________

Rabies (within 3 years): _________________________________________________

 

What breed or mix is your dog? ___________________________________________

What is your dog’s age? ___________________              Sex:  £  Male    £  Female

Does your dog have any medical or physical problems?  £  Yes    £  N

If yes, please explain: ____________________________________________________

______________________________________________________________________

Do we need to administer any medications during your dog’s stay with us?

£  Yes    £  No

If yes, please list the medication and dosage: ________________________________

Is your dog been spayed/neutered?  £  Yes    £  No

Has your dog ever been aggressive towards humans?  £  Yes    £  No

If yes, please explain: ____________________________________________________

_____________________________________________________________________

Has your dog ever been aggressive towards other dogs?  £  Yes    £  No

If yes, please explain: ____________________________________________________

_____________________________________________________________________

In case your dog should need medical attention during their stay, we have permission to take emergency action, if necessary, and the liability for any fees incurred will be on the owner. Please provide the name and phone number of your veterinarian

Name: _____________________________ Phone: _____________________________

Do you want your dog to have free range?  £  Yes    £  No

If so, even though all activity is supervised, we want you to understand that during the course of play, they may possibly be injured

Gracious Kennels is not responsible for any accident or injury that may be incurred by your dog during their stay at the facility. We will make every effort in our expertise to make sure that your dog is safe at all times and that someone will always be supervising them.

______________________________________    Signature of Owner                                              ______________________________________ Signature of Kennel Employee

Check In :     Date : _______________________  Time : _______________________

Check Out : Date : _______________________  Time :  _______________________

 

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