Animal Daycare & Boarding

Intake Form


Ownerís Name                                                    Address                                                                        Zip                   Home Phone                       


Cell Phone                  Work Phone                       Email                                                Emergency Contact                             Vet Clinic                                   

          Pet's Name                          Breed                          Sex              Age & Birthdate                 Neutered/Spayed

1)________________________________________________________________________________________              Yes    or    No


2)_________________________________________________________________________________________             Yes    or    No 

3)__________________________________________________________________________________________            Yes    or    No

Separation AnxietyEscape ArtistDominance LevelAggression Level FearfulnessBarking Amount
1)     Yes         No
       Yes         No      High           Low    High           Low    High           Low    High           Low
2)     Yes         No
       Yes         No      High           Low    High           Low    High           Low    High           Low
3)     Yes         No
       Yes         No      High           Low    High           Low    High           Low    High           Low

Feeding Schedule:   How much & how often

Medication Schedule:  How much & how often






3)____________________________ _____________

I give Animal Daycare & Boarding full authority to make any & all decisions concerning the care & keeping of my pet(s) 

while my pet is in their care.  If medical attention is deemed necessary, while my pet is in the care of Animal Daycare & 

Boarding, I authorize emergency medical treatment by a local veterinarian and will take full responsibility for the costs.


________________________________________________________________ ____________________________________

    Signature                                                                                                                                            Date

____  Normal Boarding Rate   ___  Multiple Dog Discount   ___  Special Needs Boarding Rate

____  Part-Time Daycare        ___  Full-Time Daycare                 








Animal_Daycare_Logo  Animal Daycare & Boarding


We agree to care for your pet(s); we will supervise your pet, looking out for his or her safety and well-being.  We will keep the premise sanitary and properly enclosed.  Your pet will be fed regularly.  We only administer the medications you provide; we follow the instructions prescribed or those you give us.  In the event of an injury or medical emergency we will take your dog to a local veterinarian and pay for the visit and invoice your for the costs.

I __________________________________ certify that my pet(s) ____________________________________                                        


















I am the legal owner of said pets and/or I accept full responsibility for the services rendered.


My pet(s) is in good health and has not been ill with any contagious condition in the last 90 days.


My pet has not shown aggressive or threatening behavior such as biting or attacking people or dogs.


I provided proof that my dogís vaccinations for Rabies, Parvo & Distemper are current.  I understand that AD&B recommends dogs also be vaccinated for Bordetella (Kennelís Cough) and receive a monthly preventative for canine lice.


I accept the risks involved with my dog interacting with other dogs in an open group setting.  These risks include, but are not limited to scrapes, cuts, dog bites, viral and bacterial infections. 


If my dog gets into a fight with another dog and either dog is injured and needs to go to the veterinarian I understand Iím responsible for the costs of my dogís vet bill and if my dog was observed as initiating the fight I will be responsible for the other dogís vet bills.


Should my dog become ill, harmed, or seem to be in need of medical attention; I authorize AD&B the right to administer aid and/or utilize a local veterinarianís services.  I agree to pay all medical treatment costs. 


I understand AD&B is not liable for loss or damage from disease, theft, fire, death, injury, and harm to persons, dog(s), pet(s), and property, or from other unavoidable causes.


I take full responsibility for any harm caused to self, people with me, or their pet(s), during drop off, pick up, or while on AD&B property.


Iím aware that AD&B will consider my dog abandoned if I have not picked up my dog or extended boarding services within 72 hours of the provided pick-up date.  Unless another home can be found for the dog, s/he will be turned over to the Anchorage Animal Care & Control Center along with your contact information.


Full-time Daycare is a monthly rate & is not reduced for vacations, holidays, or missed days.


AD&B reserves the right to refuse service to any owner and their pet(s).

      _______________________________________________________________      ___________________________

          Owner's Signature                                                                                                                                                         Date

  Site Map