Daycare Enrollment Form

2544 Rock Hill Industrial Court St. Louis, MO 63144 • tel. 314-963-PAWS (7297)



Part 1: Biographical Information

Owner Information
Dog Profile
Male, intact
Female, intact
Male, neutered
Female, spayed

Please note: All dogs must be either spayed or neutered by 9 mos of age to participate in Daycare or Boarding.

Purpose

For which service(s) are you enrolling? Check all that apply.

Daycare
Occasionally (1-2 days per month)
1 day per week
2 days per week
3 or more days per week

Boarding
Emergency Contact Information

If we can't reach you, who should we contact in case of emergency?

Other Information

Note: Our evaluation is a trial day of daycare set by appointment Mon-Fri. Please plan to arrive between 7:00 - 8:30am and stay for approx. 20 minutes.

Yes
No

 

Yes
No

 

Angie's List
APA Canine Carnival
From a friend/referral
Newspaper/ Magazine
Tails Magazine
Tame Magazine
Ladue News
Webster-Kirkwood Times/ South County Times
Rock Hill Fall Festival
Vet Clinic
Web Search
Other

 



Part 2: Behavioral Information

 

Yes      No

 

 

Yes      No
Yes      No

 

Rarely      Few times per week      Daily

 

Yes      No
Yes      No

 

 

 

While playing     As a warning

 

Yes      No
Yes      No

 

Yes      No
Yes      No

 

 

Yes      No

 

Yes      No

 

Yes      No

 

Yes      No

 

Yes      No      Dog is crated when left alone

 

Yes      No

 

 

 

 

Yes      No

 

Yes      No