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

Date of Arrival *

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.

Time of Arrival *

Week-ends are set rates. We are NOT OPEN FROM 10.30AM Saturday to 3.30PM Sunday.

Departure 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.

Departure TIMES – All morning pickups must before 8.30am, otherwise Fees apply. *

NOTE – All morning pickups must be before 8.30am. For ALL morning PICKUPS AFTER 8.30am will incur a fee of $20 (Off Peak) & $25 (Peak) PER DOG.

Dog name/s & DOB / Age? *

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

Breed/s & Colours *

Brief Description of your dog/s.

Sex *

Male
Male (neutered)
Female
Female (neutered)

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 *

Tick & Flea. MUST BE DONE WITHIN THE LAST 5 DAYS. *

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. Please sent through a copy prior to coming into kennels.

File Upload

Click or drag files to this area to upload. You can upload up to 4 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.

Any medical condition needing attention? *

Yes
No

Special Needs, Medical History or other special needs.

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

Is your Dog/s on MEDICATION? No or if Yes. State product name, dosage and when to be given.

All medication must have the prescription of the vet’s dosage on items. If you have the box with the details it is important that you bring that along with you.

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

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

Emergency contact (DO NOT PUT YOURSELF DOWN HERE) *

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 or there emergency contact person. 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. Do not take to the Vet. (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, what do you wish us to do with the body? If we can't contact you, we will call your emergency contact person. *

Will discuss on Drop Off (Please make sure that you do discuss with us your wishes).
Take the body to the vet to keep for us. We will let the vet’s know you are coming.
Let us know and we will make arrangements for cremation.
Please dispose of the body in a fit and proper manner.
Do not know will advise!!!!!!

You will always be our first phone call. I know this is hard, it is hard on everyone, but if something happens we have to know. Please give this some thought. eg, we will collect immediately, cremate – bury here, take to the vet. If you have pet insurance they may cover cremation.

Indicate how social your dog/s are: (This is very important for us to know) *

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, Doesn’t like men or women, scared of loud noises, etc

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

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 & when you feed your dog: ( please tell us how much food you feed your dog / day.) Include any SPECIAL DIET. All special diets must be provided by the owner. *

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? *

Additional information? (include any updates to your personal details) *

Please reframe from bring toys, bedding and dishes.

Deposit Required for Booking – 3 days cooling off period

– Off Peak – $38

– Peak – 50% deposit.

Cancellations Fees *

Off Peak – $38 | Peak – $100 if cancelling more than 25 day from arrival OR forfeit of full deposit for less than 25 days from arrival.

I agree to the Terms and Conditions *

I have read, understood and agree to the Terms & Conditions