Name *

First Name

Last Name

Phone

(###)

###

####

Other Emergency Contact: Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Veterinarian Phone *

(###)

###

####

In the event of a medical emergency, we will attempt to contact you immediately and will continue to keep you updated on your dog. If it is possible to get your dog to your preferred vet, we will attempt to do so; otherwise, we will take your dog to another appropriate emergency vet. If we cannot reach you, emergency medical treatment will be given, and you will be responsible for financial costs of the treatment.

Please check here to indicate that you understand and agree to the policy above.

Sex *

Intact Male

Neutered Male

Intact Female

Spayed Female

Type of Measurement *

Standard 8oz measuring cup (no need to send yours along)

Different type of scoop or cup (please send your scoop)

Select this option if you plan to send your dog's meals pre-portioned

Is your dog on any type of medication? *

Yes

No

Does your dog receive any other supplements, or regular treats/chews? *

Example: dog gets a Greenie for dental health once a day

Yes

No

Does your dog have any allergies, sensitivities, or food/treat restrictions? *

Yes

No

Does your dog have any other relevant medical history, problems, or information I should know? *

Yes

No

Eating Habits *

My dog typically eats relatively quickly, and finishes his entire meal at once

My dog eats slowly, or may walk away from the bowl and return later, but typically finishes his entire meal

My dog will occasional leave food in the bowl and not finish his entire meal

My dog never finishes his meals, or is free fed (food left out at all times)

Leash Behavior *

Please select all that apply:

My dog has chewed through a leash

My dog has slipped out of a collar/harness

My dog has broken off of a leash, broken a collar, etc.

My dog has never successfully chewed through, slipped out of, or broken off of a collar/leash, but has attempted to

My dog has never attempted to do any of the above

Escape Attempts *

Please select all that apply:

My dog has climbed fences or gates up to 4' tall

My dog has climbed fences or gates up to or over 6' tall

My dog has dug under fences, or found holes in fences, to escape through

My dog has escaped from wire crates

My dog has escaped from plastic crates

My dog has attempted to escape from a crate/kennel/fenced area, but has not been successful

My dog has never escaped from a crate, kennel, or fenced area

Destructive Tendencies *

My dog will destroy bedding, toys, or other items within reach, and may consume pieces he tears apart

My dog will destroy bedding, toys, or other items within reach, but does not generally consume pieces

My dog does not generally destroy bedding, toys, or other items

Dog-Directed Aggression *

My dog has bitten another dog

My dog has displayed aggression towards other dogs, but never bitten

My dog has not displayed aggression towards other dogs

Human-Directed Aggression *

My dog has bitten a person

My dog has displayed aggression towards a person, but never bitten

My dog has not displayed aggression towards any person

Training tools may be used on boarding dogs at Canine Initiative's discretion to ensure the safety and wellbeing of all dogs and people involved. These trainings tools may include, but are not limited to: slip leads, training collars, muzzles, electronic bark collars, squirt bottle, compressed air, etc. *

I understand and give my permission for the use of training tools with my dog, as needed

Training/Enrichment Sessions *

I would like my dog to receive training sessions while boarding

I would like my dog to receive enrichment sessions while boarding

I would like my dog to receive either training or enrichment sessions while boarding

I do not want my dog to participate in training or enrichment sessions while boarding

If you are wanting your dog to receive training/enrichment, how many sessions would you like the dog to receive?

(Sessions will be done as time allows - requesting sessions does not guarantee that that number of sessions will be done.)

Up to 1 session/day

Up to 2 sessions/day

Up to 3 sessions/day

As many as time allows (please note that time rarely allows for more than 3 sessions/day)