VIP Boarding Intake Consultation Form

Client & Dog Information

Name *

First

Last *

Last

Chosen pronouns (if you'd like to share)

Email Address *

Secondary Email Address (optional)

Cell Phone (numbers only, no dashes) *

Home Address *

Home Address

City

State/Province

Zip/Postal

How many dogs are you requesting VIP Boarding for?

1 dog

2 dogs, from the same household, who have lived together for at least 6 months

If requesting VIP Boarding for more than one dog, both dogs must be from the same household and living together for at least 6 months to be boarded together. EACH DOG REQUIRES THEIR OWN INTAKE FORM. Complete this form for one dog and then complete it again for the second dog.

Dog's Name *

If bringing two dogs from same household, please complete this form TWICE - once for each dog. DO NOT enter both dogs' information on this one form or your request will be denied.

What's your favorite thing about your dog? *

We'd love to see your favorite picture of your dog! Share it here.

Maximum file size: 52.43MB

Weight/Breed/Age/Sex *

Spayed/Neutered *

Yes

No

How old was your dog when you got them? *

Household Information - HUMANS (please list everyone who lives in the home -include ages of minors) *

Household Information - ANIMALS (please list all cats/dogs or other animals your dog interacts with: include ages, species, breed, weight, how long in the home and whether they are spayed/neutered) *

Vet & Health Information

Primary Vet Office/Vet's Name *

Primary Vet's Phone Number (numbers only no dashes) *

Are you also working with a Veterinary Behaviorist (VB) or vet specifically for behavior concerns?

Yes

No

If you are working with a VB or other behavior vet, please list their name and contact information here. *

N/A if not applicable

If you are working with a VB or other behavior vet, please contact them and have them send me a copy of the behavior summaries/records for your dog. This will help me thoroughly analyze your dog's needs and behaviors.

I will contact them in the 24 hours. I understand my intake form will not be fully processed until these records are received.

I have all the records and will upload them here.

My dog does not see a VB or behavior vet so there are no records to review.

File Upload for VB or behavior vet records (PDF preferred)

Maximum file size: 52.43MB

Current Medications, Dose, Frequency & Reason for Medications (include preventatives, supplements or other oral or topical things you give you dog) *

Is your dog current on rabies, parvo, and distemper vaccinations, and free of intestinal parasites and communicable illnesses? If not, please describe. PLEASE NOTE: You will be required to provide a copy of up-to-date vaccination records when booking the boarding assessment. Recent titers are accepted for parvo and distemper. *

Other Important Medical History Notes (allergies, anal gland issues, GI issues, ear infections, etc.) *

N/A if not applicable

Your Planned Trip/Dates & Emergency Contact

Emergency contact must be local, within 100 miles and able to act as your surrogate for decision making in the event I cannot contact you and to pick up the dog in the event of an emergency like hurricane evacuation or safety issue.

What dates are you looking to book VIP Boarding? *

Please describe any special needs your dog has, if any.

Does your dog have any health, exercise or physical restrictions? *

Where will you be staying during the dog's VIP Boarding? Please provide any contact information if you will not be home including, hotel phone number and location. *

Emergency Contact Name (in the event we can't contact you) *

Emergency Contact's Email Address

Emergency Contact's Cell Phone Number (numbers only no dashes) *

Emergency Contact's Home Address *

Emergency Contact's Home Address

City

State/Province

Zip/Postal

Dog's Routine

Describe your dog’s daily routine. Please include specific times regarding walk, meals, training, other exercise and bed/napping times. *

Please describe your dog's meals, including times, quantities, type/brand of food, and any toppers. Please be specific. For example: Meals are at 8am and 5pm, 1 cup of kibble (Fromm's) at each meal. No toppers. *

Please describe any food allergies or food sensitivities that your dog has. *

What is your dog's typical potty schedule (including poop frequency and time) schedule? Example: Poops twice per day, once during the first morning outing and then again 30 minutes after dinner. *

What is your dog's typical walking, play, and other exercise schedule? Include times and duration of walks/play/other exercise. *

Is your dog fully potty trained? If not, please describe. *

If you use a crate for any purpose, please describe the context(s) you use it, and your dog's comfort level with entering and resting in it with the door closed. If you don't crate at all, please indicate that. *

Does your dog display anxious or fearful behaviors in any of the following contexts? Select as many as apply.

Fireworks

Thunderstorms

Loud sounds other than fireworks/thunderstorms (ex. motorcycles, trucks, cars backfiring)

High-pitched sounds

Getting in or out of the car/car rides

Easily startled on walks or being outside

General fear or anxiety in daily life

None of the above

OtherOther

Where does your dog sleep at night? Select as many as apply.

In your bedroom, on your bed

In your bedroom, on a dog bed

In your bedroom, crated

In another room, on a dog bed or couch

In another room, crated

My dog moves around throughout the night and is not confined

OtherOther

Is your dog allowed on couches/human beds?

Yes. My dog hangs out on the couch with family most of the time.

Yes. But, my dog usually prefers the dog beds and some space.

No. My dog is not allowed on couches/furniture..

OtherOther

What are your dog's favorite activities? Examples: going on walks, chewing on bones/chew toys, cuddling with humans, playing with squeaky toys, tug games, fetch, food-scavenging games, digging, chasing squirrels, playing with other dogs. *

Is there anything else about your dog's daily routine that you want to mention or that I missed asking?

Training & Boarding History

Please describe what training you've done with your dog so far, either on your own or with a trainer. Include the names of any previous trainers you've worked with or books/videos you've used. *

Has your dog ever been boarded at someone else's home or a boarding facility? If so, how did it go? *

Fear or Aggression Toward Humans

Has (Spot's) mouth made contact with a person during any of the incidents? For this question, a bite means any tooth contact on a human or their clothing, other than mouthing/teething as a young puppy. This includes behaviors you might consider a "nip" if contact was made. *

Yes

No

Please describe each bite incident in detail, including what was happening before the bite, what triggered the bite, date and what happened after the bite. *

Type "NA" if not applicable.

Please describe any additional details about your dog's interactions with unfamiliar people. *

Type "NA" if not applicable.

When meeting an unfamiliar person, how long does it take for your dog to "warm up" and allow petting/touching by that person? *

Immediately allows petting and interaction

1-2 minutes

10-30 minutes

More than 30 minutes

It takes several meetings for my dog to warm up

Does your dog growl, snap, or display other guarding or "possessive" behavior toward people around any of the following? Select as many as apply. If yes, which items? *

Toys or other dog objects

Food bowl/food

Treats or chews like bully sticks or bones

Trash, paper towels, socks, or other household items

Beds, couches, or other resting spots

Favorite person

OtherOther

None of the above

Does your dog avoid, run away, growl, snap, or bite when being touched in any of the following contexts? Select as many as apply. *

Putting on harness

Putting on/touching their collar

Touching/wiping paws

Being groomed/brushed

Wiping face/eyes

Being picked up (if a little dog)

Being pet by familiar people/family members

None of the above

OtherOther

Fear or Aggression Toward Dogs

Has (Spot's) ever injured another dog, requiring vet care (shaving, suturing and/or antibiotics)? *

Yes

No

Familiarity to dog *

Known dog on leash

Unknown dog on leash

N/A - there have been no bite incidents

Please describe each dog-dog bite incident in detail, including date, what was happening before the bite, what triggered the bite, and what happened after the bite. *

How does your dog react on-leash toward other dogs during walks or otherwise out in public? (example: barks and lunges, meets and happily interacts, ignores, hides behind you, growls) *

Does your dog play or interact off-leash with other dogs (daycare, dog park, play dates, etc.)? If so, how often and what are the interactions like? If no, note that. *

Does your dog growl, snap, or display other guarding or "possessive" behavior toward other dogs around any of the following? Select as many as apply. If yes, which items? *

Toys or other dog objects

Food bowl/food

Treats or chews like bully sticks or bones

Beds, couches, or other resting spots

Favorite person

Trash, paper towels, socks, or other household items

None of the above

OtherOther

Separation Anxiety

How long can your dog be left alone comfortably, and where is your dog when left alone? (Example: Free-roaming/no restrictions, free-roaming with doors to rooms closed, crated, baby gated in the kitchen, etc. *

Final Questions

You will receive important information via email within 3 business days after submitting this form, and throughout our time working together. Will you check your email, including your spam folder, regularly? *

Yes

No

How did you hear about me? If a personal referral, please include their name so I can thank them! *

Do you need any disability-related accommodations to participate in the boarding assessment meeting? Please feel free to share any information you like. *

Anything else we missed you'd like to share about yourself or your dog?