Booking & Consent form

Scruffs – Booking & Consent Form

Owner details

Full name *

Address *

Home phone

Mobile *

Email *

Dog 1 details

Dog 1 name *

Sex
Please choose...MaleFemale

Breed

Markings

Microchip number

Neutered/Spayed
Please choose...YesNoUnknown

Date of last flea treatment

Date of last vaccinations

Medical conditions / allergies / medication instructions

Dog 2 details (optional)

Do you have a second dog?
NoYes

Dog 2 name

Sex
Please choose...MaleFemale

Breed

Markings

Microchip number

Neutered/Spayed
Please choose...YesNoUnknown

Date of last flea treatment

Date of last vaccinations

Medical conditions / allergies / medication instructions

Feeding & behaviour

Feeding instructions

Command words your dog knows

Dog’s character / notes

Do they like cuddles?
YesNoSometimes

Nervous around loud dogs?
YesNoSometimes

Possessive with food?
YesNoSometimes

Happy to share toys with other dogs?
YesNoSometimes

Aggressive with other dogs?
YesNoSometimes

Aggressive with people?
YesNoSometimes

Other information

Vet details*

Vet name*

Vet address*

Vet phone*

Out of hours phone*

Dog insurance company*

Policy number*

Insurance phone number*

Drop off / pick up

Drop off date

Drop off time

Pick up date

Pick up time

Emergency contact (used only in an emergency)

Full name *

Address

Home phone

Mobile *

Email

Crate

Does your dog normally use a crate at home?
YesNo

If yes, describe crate use

Consents (tick to consent)

Vet may be contacted/exam and investigations performed if required
Treatment may be by usual vet or Scruffs nominated vet if needed; I accept costs
I consent to Leanne administering prescribed treatment
I consent to euthanasia if recommended on humane grounds by the vet
If fleas/worms, Scruffs may arrange treatment and charge me
My dog may mix with dogs from other households whilst boarding
My dog may be fed with dogs from other households
My dog may be walked outside home/garden with their own tag on collar
My dog may be let off lead outside home/garden
My dog may be walked within a group of dogs (max 6)
If boarding more than one dog: my dogs may be kept together
If my dog normally uses a crate: my dog may be kept in a crate as routine

Upload Your Dog Image (optional)

Signature

Name (print) *

Date *

I HAVE READ THE POLICIES AND PROCEDURES DOC. I confirm the information provided is accurate and I agree to be contacted about this booking.

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