New Customer Form – The DogHouse Inn

Name *

First

Last

Address *

Address Line 1

City

State / Province / Region

Postal Code

Phone *

Email *

Do you require Boarding or Daycare? *

Boarding
Daycare

Drop-Off Date *

ALL Charges are PER DAY during our OPENING HOURS. eg. Friday to Sunday is 3 days. The first day you will be charged whether you drop of am or pm.

Drop-Off Time *

Monday - Friday 7.00am – 10.30am
Monday - Friday 3.30pm – 5.30pm
Saturday - 8.00am – 10.30am
Sunday - 3.30pm - 5.30pm.

OUR Week-end set rates: $60 (off peak) $70 (peak) for both Saturday & Sunday during opening hours. Your times on our quote are only an estimate of arrival / departure and represent the times we are open. Outside of our Opening Hours is for EMERGENCIES ONLY and you will be charged an extra $30. We have the right to refuse opening outside of our normal hours without giving a reason.

Pick-Up Date *

ALL PICK UPS / DROP OFFS OUTSIDE NORMAL OPENING HOURS WILL BE CHARGED AN OUT OF HOURS $30 FEE extra on top of our normal rate. Please note Week-ends are a set rate of $60 (off peak) or $70 (Peak).

Pick-Up Time *

Monday - Friday 7.00am – 10.00am
Monday - Friday 3.30pm – 5.30pm
Saturday - 8.00am – 10.30am
Sunday - 3.30pm -5.30pm

Your times on our quote are only an estimate of arrival / departure and represent the times we are open.

Dog name/s & DOB / Age? *

Please indicate the name or names of your dogs THEIR DOB & age please?

Sex *

Male
Male (neutered)
Female
Female (neutered)

Breed/s & Colours *

Brief Description of your dog/s.

Microchip Number/s (If you know it)

By law all dogs should be microchipped. The

Your Dog/s Weight in kgs please? *

Estimation is fine.

Last Wormed Date *

Any specific requirements or information we should know?

The more we know about your dog, the better we can help make him/her more happy.

Date on the Vaccination Certificate - Please bring original certificate for sighting with you on day of drop off, Thank you. *

An up to Date Vaccination Certificate is required. Your dog cannot board with out it.

File Upload

Click or drag files to this area to upload. You can upload up to 3 files.

Please upload a photo or image of your dogs Vaccination Certificate.

Name of your Vet & Phone Number? *

If we need a vet urgently we will call Chinchilla Vets. If you don't want us to call them please let us know.

The Customer acknowledges and agrees that if your pet/s has an injury or illness, the necessary treatment will be administered by a veterinarian or The Dog House Inn personnel. If possible and practicable, the Customer / nominated Emergency Contact person will be contacted prior to the treatment being administered. *

Yes
No

The Customer authorises The Dog House Inn to provide personal information relating to the Customer and Pet to a veterinarian for the purposes of treating the pet’s. *

Yes
No

Any medical condition needing attention? *

Yes
No

Special Needs, Medical History or Allergies / Medication required to be GIVEN.

All medication must clearly be labeled with Name of Medication, Dog's name and Dosage as prescribed by the vet.

Indicate how social your dog/s are: *

Sociable to both humans & animals, Friendly to people only, Aggressive, Re-active to other dogs, Separation Anxiety, Scared of Storms, Jumps Fences, Chews dog beds.

Emergency contact *

First

Last

ANY OTHER Person other than yourself in the case we are unable to contact you. This person must be able to act on your behalf.

Emergency contact person's number? *

In the event of an emergency, contact me for....... *

Major incidents Only
All incident NO MATTER WHAT
At Kennel Management Discretion

No decisions will be made without consulting the owner first if possible. If is very important if you are not contactable that your emergency person is and able to act on your behalf. IF you aren't able to be contact we will try your emergency contact person. You understand that if a snake bite occurs our 1st priority is to get to the vets as quickly as we can to save your dog. We will still try to ring you 1st while we are in transit.

Medical Expense - I agree to pay........ *

Yes, only up to the cost of $1000.00
Yes, up to the vets discretion (no price limit)
No (You have agreed, as the owner to take FULL RESPONSIBLITY FOR ANY INJURY OR DEATH. if something was to occur.

You the owner, waiver your right to hold The DogHouse Inn of all responsibility from calling the vet immediately in an emergency. You immediately recognize & take full responsibility of all outcomes whether good or bad, including but not solely any death or injury to your dog/s especially if time is of the essence.

In case of death: Yes you will be our first call *

Contact my emergency contact
Will discuss on Drop Off
Do not know

You will always be our first phone call. I know this is hard but if something happens we have to act fast. Please give this some thought. eg, we will collect immediately, cremate - bury here, take to the vet.

Additional Services we Offer? NOTE: These options may not always be available at time of booking.

Hydrobath - $30
Nails - from $18 - $30
Medication Required to administer - fr $2.50. per day.
Worming - $5.50 per 10kg tablet.
Fan - $5 per day
Bitch in Season ($5.00 per day)
You require us to provide dry biscuits? POA The cost will be added to your bill.
No, Thank you.

Any costs relating to the above will be charged and payment due at time of pickup if they aren't stated when booking form processed. NOTE: We are not GENERAL ANIMAL REMOVALS.

Do you give Permission to take photos, & use in any multi-media format? *

Yes
No

All photos, vidoes, etc are the property of The DogHouse Inn and are not for sale.

Food you will supply & how much do you give your dog: ( please tell us how much food you feed your dog / day.) Include any SPECIAL DIET *

For the well-being of your pet, we only require their dry biscuits which they eat everyday. The reason being that your dog is use to his/her own food, which is comfort to them. Also by not changing there normal food they won't get an upset stomach.

How did you here about us? *

Anything that we should know about your pet to help make his/her stay better here. Please list all items here which you are going to bring along. *

Please reframe from bring toys and bedding and dishes we have heaps of these products for your dog to use. We cannot always guarantee you will get these items back so we ask if you could not bring them along in the first place. (incl colour / size of leads if leaving behind)

I agree to pay the deposit of $35 (Off Peak) or 50% (Peak) at time of booking to guarantee my place for my dogs once my quote comes through. I understand & accept this and will forward the deposit along with my confirmation of booking once I receive the quote sent to me. NO BOOKING WILL BE KEPT LONGER THAN 3 DAYS WITHOUT CONFIRMATION. *

The above statement forms part of the Terms of Service we offer and we ask that you read this before sending through your booking. When confirming your booking please submit your remittance payment so we can credit your account.

CANCELLATION POLICY: I understand & accept that if I cancel a booking the cancellation fee of $35 (Off Peak) or $100 (Peak) will be deducted from my deposit. This is part of the Terms of Service which I have agreed to. (We strongly suggest you read these before submitting). *

ABSOLUTELY NO BOOKING will be accepted under ANY CIRCUSTANCES UNLESS THE 50% DEPOSIT (Peak) or $35 (Off Peak) IS PAID AT TIME OF confirmation. All bookings are to be confirmed within 3 days of receiving their quote otherwise we believe that you no longer wish to board your dog/s. CANCELATION: Notice given more than 25 days prior to entry (peak) are refunded less than $100 cancellation fee, which will be deducted from your deposit at Peak times or all other times is $35 Off Peak (non refundable). Canceling less than 25 days there is no refund on Peak Periods.

I agree to the Terms and Conditions *

I have read, understood and agree to the Terms of Service