Northport
Play'n'Stay
Dog Day Care and Boarding
Call or Text Us !
205-861-4967
Welcome
About Us
Contact
Services
Schedule
Pricing
Checkin
Registration
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Dog Information
Dog Name:
Dog Breed:
Color:
Age:
Sex:
Weight:
Birthday:
Is your dog spayed/neutered?
yes
no
Upload Vaccination Records (then enter the dates below)
Click or drag a file to this area to upload.
Most recent Rabies Vaccination Date
Most recent DHPP Vaccination Date
Most recent Bordetella Vaccination Date
Owner and Contact Information
Full Name:
*
Address:
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email:
*
Phone:
Emergency Contact (can NOT be same as above)
Full Name:
Phone 1:
Email:
*
Phone 2:
Veterinarian Information
Name of Clinic:
*
Veterinarian Name:
*
Phone:
Address of Clinic:
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Dog/Family Information
When and where did you get your dog?
Does your dog have any allergies? If so, what are they?
Is your dog on flea, tick & heartworm prevention (REQUIRED)? What brands?
*
Does your dog have any sensitive areas on his/her body? If so, where?
Home Life
Are there any other animals in your household? If so, please list type, age, and sex.
Is your dog crate-trained for the day? For the night?
Where does your dog stay during the day normally? At night?
Behavioral Information
How does your dog get along with other animals?
Has your dog been around other dogs? Where?
Has your dog ever bitten another dog or person? What were the circumstances?
Are there any type of dogs or people your dog automatically fears?
What kind of toys does your dog like?
Does your dog play with other dogs? If not, are they comfortable around other dogs?
How does your dog react to strangers coming into your yard?
Is your dog sensitive to having the collar held?
Yes
No
If possible, Please explain
Does your dog like to be brushed?
yes
no
If possible, Please explain
Does your dog like to be petted?
yes
no
If possible, Please explain
Does your dog like children?
yes
no
If possible, Please explain
Does your dog like puppies?
yes
no
If possible, Please explain
Can your dog jump fences?
yes
no
If possible, Please explain
Does your dog eat/chew up toys?
yes
no
If possible, Please explain
Has your dog ever been boarded before?
yes
no
If possible, Please explain
Does your dog tend to get fleas?
yes
no
If possible, Please explain
Does your dog tend to get ticks?
yes
no
If possible, Please explain
Is your dog afraid of specific items or noises (e.g., thunder)?
yes
no
If possible, Please explain
Does your dog have a problem with:
yes
no
If possible, Please explain
Jumping
yes
no
If possible, Please explain
Barking
yes
no
If possible, Please explain
Housetraining
yes
no
If possible, Please explain
Do you use training aids or collars?
yes
no
If possible, Please explain
Additional Information
FEEDING AMOUNT:
AM/PM
OTHER INFO:
Payment for Services:
At Northport Play’n’Stay Doggie Day Care, we look forward to many happy visits from you and your pet. Our goal is to create a comfortable and familiar place for your pet to visit. For convenience, our established clients may pay when they pick up their pet.
Please note that new clients may be required to prepay.
We accept cash and checks. If a check payment you provide to us is returned unpaid, and you correct the error, we will gladly continue to accept checks as payment on your account. If you do not correct the error, your account with us will close and we will, at our discretion, notify other pet facilities of the payment failure.
Policies and Disclaimers
No Pet can stay with us unless the Pet is healthy and we have confirmation from a licensed veterinarian that the Pet has received all vaccinations required (Rabies, Bordetella, DHPP). Your pet must also be current on heartworm prevention and a flea/tick preventative. If at any time your Pet is found to have fleas or ticks, we may provide the appropriate flea or tick removal treatment, and you authorize us to provide such service at your additional expense. If your Pet has been treated for a contagious illness, we cannot accept your Pet for at least two (2) weeks after treatment has been completed and a statement of health is obtained from a licensed veterinarian. While your Pet is staying with us, he or she will come into contact with other Pets. Every effort will be made to ensure the safety of our guests by enforcing strict restrictions on Pets. You acknowledge and agree that in the unlikely event your Pet is injured by another Pet, YOU RELEASE NORTHPORT PLAY’N’STAY AND ITS AGENTS FROM ANY LIABILITY FOR SUCH INJURY. If your Pet injures another Pet, you will be solely responsible for any injury to the other Pet(s) as well as your own Pet, and YOU RELEASE NORTHPORT PLAY’N’STAY AND ITS AGENTS FROM ANY LIABILITY FOR SUCH INJURY.
I have read and agree with the policies of Northport Play’n’Stay. I certify that my dog
is in good health and up to date on immunizations (Rabies, Bordetella, DPP). I understand and agree that any problems which develop with my dog will be treated as deemed best by staff and volunteers of Northport Play’n’Stay and I assume full financial responsibility for all expenses involved. I further understand that Northport Play’n’Stay, and staff and volunteers, will not be liable for any problems which develop, provided reasonable care and precautions are followed, and I hereby release them of any liability arising from my dog(s) attendance at the camp.
Date
*
Signed by:
*
Date / Time
Date
Time
Name
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