LODGING REQUESTS - Pine Ridge Pet Centre

Are you an existing client?

Yes - Log into your account No - Complete application form

Owner Information

First Name

Last Name

Address Line 1

Address Line 2

City

Province/State

Postal Code/Zip

Referral Type

Contact Information

Confirm Email

Home Phone

Work Phone

Cell/Emergency Phone

Reservation Information

Please select the service type

Lodging Request Daycare

Daycare is for dogs only.

Pet Information

Is your pet a dog or cat?

Dog

Cat

Name of Animal

Birth Date (Month / Day / Year)

/ /

Breed or Cross-Breeds

Breed, DSH or DLH (Domestic Short Hair or Long Hair)

Sex

M F

Weight (LBS)

Colour

Pet Health Information

Spayed or Neutered

Yes No

Method of Flea & Tick Control All animals must be treated for fleas & ticks.

Has your animal had any form of worms in the last six months?

Yes No

Has your dog been fully vaccinated with DHPP, Rabies and Bordatella? Has your cat been fully vaccinated with FVRCP and Rabies?

Yes No

We require proof of these vaccines.

If "YES", and you have the vaccines available, you may upload them now. Otherwise you will need to provide them later. Approved file types: *.doc, *.docx, *.jpg, *.jpeg, *.pdf, *.bmp, *.tif, *.tiff, *.txt
Max upload size: 10MB

If "NO" please explain.

Is your dog on medications and/or supplements?

Yes No

Medication Name	Dosage	Time
		Morning Afternoon Evening

Are you aware of kennel cough?

Yes No

Has your dog ever had kennel cough?

Yes No

Has your dog ever had seizures?

Yes No

Has your dog ever had a stroke?

Yes No

Has your dog ever bloated or had gastric torsion?

Yes No

Does your animal cough, sneeze, wheeze, or exhibit any asthmatic symptoms?

Yes No

Has your animal had any infections in the last six months (ear, eye, bladder or urinary)?

Yes No

Has your animal been diagnosed with any health conditions?

Yes No

If "YES" please state conditions.

Name of Veterinary Clinic

Veterinary Clinic's Phone

Does your dog require medication prior to entering your vet clinic?

Yes No

Medication Name

Medication Quantity

How often do you lodge/board your dog per year? How often do you lodge/board your cat per year?

Is this your first dog?

Yes No

Please let us know the breed(s) of dogs you've owned prior

Where did you get your dog from?

Please specify

Name

What was the age of the dog when you obtained it?

Has your dog had obedience training?

Yes No

Name of training facility

Name of trainer

City where your dog attended obedience training

What age did the dog start its training and how many classes did the dog attend?

When the dog stopped classes, how old was the dog?

Has your dog ever been boarded or attended a doggie daycare?

Yes No

Facility

City

Date Last Boarded

If you have another pet, click the button below to add them to this reservation.

Add Animal

Note: A minimum stay of 3 nights required unless otherwise specified for a certain period.

Arrival Date (Month / Day / Year)

Arrival Time

Departure Date (Month / Day / Year)

Departure Time

Please select daycare type

Drop off/pickup Safe Paws Transit

Daycare Date (Month / Day / Year)

Morning drop offs & Afternoon pickups only for Daycare

Arrival Time

Departure Time

Safe Paws Transit Date (Month / Day / Year)

Would you like your animal(s) cared for adequately?

Yes No

Are you shopping for boarding rates for the lowest cost?

Yes No

I have read and agree to the business policies for the lodging/daycare request and its respective reservation