Board and Train intake form - Howling Moon Pet Care

Stay and Learn Intake Form

Please fill out all required fields for form to properly submit. To check if form has submitted, click "Fill out intake form" button again.

"*" indicates required fields

First and Last Name*

Preferred Pronouns

Please list the other humans in the home and ages of children in the home.*

Please list name, breed/type, sex, and age of all other pets residing in the home.*

Address*

Street Address City State ZIP Code

Phone*

Email*

Please list an emergency contact that will be available in the event that there is an emergency while you are out of town.*

Dog's Name*

Dog's Age*

Dog's Breed*

Dog's Sex*

Dog's Weight*

Dog's Color*

How did you hear about us?*

Is your dog neutered/spayed?*

How did you obtain your dog? (Breeder, Rescue, Family, Stray, etc.) How old was your dog at the time? Please describe your dog's history prior to joining your family, if known.*

Please list any health conditions your pet has that you are aware of :*

Your dog's Primary Veterinarian (DVM)*

Does your pet have Health Insurance? If yes, please list the company and policy number.*

In the event of an emergency, if I am unable to be reached, I give permission for life saving medical care to be performed not exceeding the dollar amount listed below.*

Is your dog up to date on vaccinations?*

Upload a copy of vaccination records now? (Or email within 48 hours of trial night)*

Please upload a copy of your vaccination records*

Max. file size: 256 MB.

What brand of Flea/Tick, and Heartworm/Internal Parasite Preventatives do you use?*

Please list any known allergies your pet has.*

Please list any medications (as needed or daily) as well as any supplements your dog is currently on. Be sure to include the dosing used.*

Is there a specific package you're interested in?*

Do you have particular dates in mind? Please enter below.

What brand of food does your dog currently eat?*

Describe your dog's feeding ritual. Please include the amount of food your dog eats.*

What type of treats do you currently use when training your dog?*

We feed during training and at meal times using enrichment feeders, such as KONG or puzzle toys. Are there any materials, specific toys, or other cautions (such as resource guarding, material shredding, or ingestion) we should know about?*

Do you crate your dog? If so, when?*

How long do you leave your dog alone each day? Are they usually crated or confined during this time?*

What items do you typically leave in the crate with your dog? Bedding, chews, water?

What type of equipment have you used with your dog for leash walking? (Flexi/retractable leash, front/back clipping harness, head halter, choke chain, prong collar, etc)*

Does your dog usually go on walks or in the backyard to potty?*

How many times is your dog taken outside to potty? Describe any details about their daily schedule that you think we should know.*

Has your dog ever escaped confinement? (Digging under or jumping over fences.)*

Has your dog ever tried to or successfully escaped from a collar or leash? Please describe.*

Is your dog allowed on furniture inside the home?*

How does your dog typically ride in the car? (In a crate, with a seatbelt and harness, in a car seat, etc.)*

What cues does your pet already know?*

Have you ever used a shock collar?*

Are you considering using a shock collar? (This includes an invisible fence.)*

How do you currently discipline your dog?*

How do you currently reward your dog?*

Have you ever used a clicker to train a dog?*

How does your dog react to other dogs while on leash?*

How does your dog react to other people while on leash?*

Has your dog ever growled at another dog? If so, what were the circumstances?*

Has your dog ever growled at a person? If so, what were the circumstances?*

Has your dog ever bitten another animal? If so, please explain.*

Has your dog ever bitten a person? If so, please explain.*

List any circumstances or things your dog is afraid of:*

List any circumstances or things that your dog is aggressive towards:*

Have you and your dog ever participated in dog training with another company? If so were they private lessons or group classes? Where were they and what was the topic covered?*

What are your immediate goals for training?*

What are your long term goals for training?*

Are you considering rehoming your dog due to behavioral or other reasons?*

What time do you usually let your dog out in the morning and evening? Describe any details about their daily schedule and routine that you think I should know.*

Does your dog usually go on walks or in the backyard to potty?*

How does your dog typically ride in the car? (In a crate, with a seatbelt and harness, in a car seat, etc.)

Read & Initial

Please initial at the bottom of each of the following to indicate that you've read and agree to the following terms:

I understand that all sales are final. Please initial.*

I understand that I will need to complete a virtual consultation and that my dog will need to complete a 24-hour trial stay in order to determine if my dog is ready to participate in a Stay and Learn program. I understand that fees for these services are non-refundable after services are completed, regardless of the outcome. Please initial.*

I understand that an ongoing commitment to recommended management, and to following the training as shown in videos, and in the provided homework and handouts, is necessary and must be made by myself and any other people who reside in my home in order for training to be successful. Please intitial.*

I understand that I will need to schedule and attend a follow-up session no later than two weeks after the completion of the program. Please initial.*

I understand that a Stay and Learn program is inappropriate for certain behavioral challenges such as severe fear, phobias, or aggression. I understand that Howling Moon Pet Care recommends private lessons to address canine behavior modification. Please initial.*

I understand that all dogs over the age of 12 weeks should be crate-trained prior to scheduling a Stay and Learn program. I understand that my dog will be crated at night and for brief periods during the day if unsupervised. Please initial.*

I understand that during all consultation services and lessons, children under the age of 12 must be accompanied by a non-participating adult. Please initial.*

I understand that my dog must be up to date with vaccinations recommended for their age in order to participate. I understand that proof of vaccinations, administered by a Veterinarian, is required before the start of services. Please initial.*

I understand that my dog must have a negative fecal within 30 days of their scheduled drop-off date. Please initial.*

I understand that I must provide all medications and preventatives, treats, food, and chews for my dog during its stay. Please initial.*

I understand that I must be on time for scheduled drop-off and pick-up times. Please initial.*

I accept all liability if any humans, dogs, or property are harmed during the training process. Please initial.*

I understand I will be provided with a copy of Howling Moon Pet Care's Release and Hold Harmless Agreement and Veterinary CAre Temporary Agent Release Agreement. I understand that services will not begin until I have signed and returned these documents to my trainer. Please initial.*

I understand that a deposit is due to reserve my dog’s stay upon scheduling a Stay and Learn program. Please initial*

I understand that two weeks' notice is required for a cancellation of services. I understand that my deposit is non-refundable in the even a cancellation is made without two weeks notice. Please initial.*

I understand that all fees must be paid in full within 48 hours prior to the start of lessons or other services. Please initial.*

I understand my dog will receive daily interaction with a human and enrichment suitable for their age and activity level. I understand that my trainer cannot guarantee dog-to-dog socialization as a compatible canine match may not be possible. Please initial.*

Field Trip Release: I authorize my dog to be transported in a vehicle and to participate in "Out and About" training to be conducted in public spaces, including but not limited to parks, trails, or shopping plazas at the trainer's discretion. I understand that Howling Moon Pet Care is not responsible for accidents that may occur during transportation. Please initial.*

I understand that in the unlikely even that my dog becomes ill, injured, or of a suspected medical emergency, I will be responsible for any and all veterinary or emergency fees up to the authorized amount. I understand Howling Moon Pet CAre will make attempts to contact me. Please initial.*

I understand that if my dog displays signs of illness after being dropped off and soils indoors, including vomitting or diarrhea, a sanitation fee may apply. I also understand that if found to be necessary, an emergency bath fee may apply. Please initial.*

I understand that in the event external or internal parasites, including fleas or ticks, are found within 24 hours of drop-off, I will be notified. Howling Moon Pet Care may proceed to request my dog be picked up and treated for parasites as applicable. I understand and accept that a sanitation fee will apply. Please initial.*

I understand that in the event my trainer becomes incapacitated due to a medical emergency, and is unable to fulfill Howling Moon's standards of care, my dog will need to be transferred to the emergency contact I have provided above. Please initial.*

Media Release: I authorize Howling Moon Pet Care to photograph/video my dog during the training program. I authorize all photos or videos collected to be utilized for marketing and self-promotion purposes, including but not limited to, social media and the company website. Please initial.

Grooming Release: I understand that my dog will be participating in daily indoor and outdoor activities that may result in my dog requiring grooming after their stay. I understand that Howling Moon Pet Care cannot guarantee my dog will be free of naturally acquired dirt, debris, or tangles. I understand that it is recommended owners arrange professional grooming for coated dogs after services are completed. Please initial.

I understand that my dog should wear an ID tag at all times. Please initial.*

919-645-8203

Info@howlingmoonpetcare.com

Stay and Learn Intake Form

Read & Initial

Howling Moon Pet Care