Sex* Male Female
City license #
Is your dog spayed/neutered? Spayed/Neutered Intact
How did you hear about us?*
The following are the names of individuals that have your permission to pick up your dog from Puptown Girls Dog Lounge and Spa.
Emergency contact name*
Primary veterinary clinic*
Vaccinations - All dogs must have all vaccinations up to date. Owners must submit written proof of all vaccinations including kennel cough. We strongly recommend all dogs be on a flea/tick/lice prevention program.
If yes, please specify the time and amount of food. You are responsible for supplying your dog’s food:
Physical limitations or health problems*
*Please note that if your dog has been ill with a communicable or potentially communicable disease within the past 30 days, a health clearance signed by a licensed veterinarian must be received before your dog can attend daycare. Please do not bring ill (vomiting, diarrhea, eye/ear infections) or injured (sore, limping etc.) dogs to daycare.
How long have you owned your dog?
Where did you get your dog?
Has your dog been to a daycare before? Yes No
If yes, where did they attend daycare?
Reason for leaving that daycare?
Is your dog comfortable with strangers? Yes No
Does your dog get along well with larger dogs? Yes No
Does your dog get along well with smaller dogs? Yes No
Does your dog get along well with puppies? Yes No
If you answered ‘no’ to any of the last four (4) questions please describe
Does your dog prefer male or female playmates? Male Female Either
Is your dog sensitive to touch on any part of their body? Yes No
If yes, what type, where, and when?
If your dog has any special commands you would like used, write them here
Has your dog ever…? (If yes, please describe)
Growled at someone
Bitten or snapped at a person
Reacted negatively when food or toys are taken
Been in a fight with another dog
Daycare Rules and Regulations
Upload your vaccination form