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Beegan K9 Daycare/Boarding Intake Form

Let's start with some information about you!

Your name (first and last)
Email address
Phone number
Your home address

Now we want to know about your dog(s)!

Dog's name(s)
Dog's breed(s)
Dog's age(s) (approx.)
Dog's weight(s) (approx.)

Emergency Contact Information (different household than owner)

Name (first and last)
Phone number

Veterinary Information

Primary clinic
Preferred doctor
Phone number
Spayed or neutered?
Untitled multiple choice field
A
B
C
Are there any medications your dog takes on a regular basis? If so, what are they? What are they for? And what dosages do they require?
Untitled multiple choice field
A
B
Does your dog have any allergies? Please explain if so.
Are there any area(s) on your dog that have been injured in the recent past or that they do not like to have touched?
Untitled multiple choice field
A
B
Is your dog aggressive towards other dogs or people? This will not impact their likelihood of attending daycare, we just like to be informed to keep everyone safe.
Untitled multiple choice field
A
B

Upload Vaccination Documents

Before submitting this survey, you are required to upload a copy your dog's vaccination records below. This is so that we can keep all of our dogs safe! The required vaccinations include up-to-date 1. Rabies and 2. DHPP (Distemper, Hepatitis, Parvovirus) shots. 

Please carefully read and review items 1-10 listed in the Client Consent Agreement for Daycare and Boarding linked below. If you have any questions at all, reach out to us at bk9beegan@gmail.com

https://beegank9.com/?page_id=2651

By signing below, I certify that I agree to items 1-10 pertaining to rules and regulations of Beegan K9 Solutions LLC and accept all the Terms, Conditions, and Statements of the above linked Agreement titled "Client Consent Agreement for Daycare and Boarding".

Signature

Print full name

Today's date

Congratulations! Upon submitting this form, you will be redirected to a page to schedule your dog's evaluation. MAKE SURE YOU DON'T EXIT OUT OF THE NEXT PAGE WITHOUT FIRST SCHEDULING AN EVALUATION DAY! IF YOU DO, REACH OUT TO 216-399-9245 FOR ASSISTANCE.