D O G Dog's Name * Breed/Type * Dog's D.O.B. MM DD YYYY Dog's Age * Dog's Weight * Dog's Sex * Male Female Is your dog spayed/neutered? Yes No Dog's microchip number * Dog's Microchip registered address * Address 1 Address 2 City State/Province Zip/Postal Code Country Does your dog wear an ID tag? * Yes No Dog description * Colours, markings, anything distinctive (to be used in case of escape/emergency). O W N E R Name * First Name Last Name Residential Address * Please provide the address where the dog and human reside. Address 1 Address 2 City State/Province Zip/Postal Code Country Work Address If your dog will be with us while you're at work, please list your business address. Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * (###) ### #### WhatsApp Number * We communicate via WhatsApp. Please confirm your WhatsApp number here, especially if different from your phone number. Country (###) ### #### Primary Email Address * Please provide the email address you'd like to use for bookings, invoices, and all written communication. Please ensure you check your spam/junk box for your first emails from us! They come from info@westendtails and Acuity Scheduling. Is your daycare need an ongoing or one-off requirement? * Ongoing One-off Requested daycare start date * Please provide the date requested for your first booking. MM DD YYYY What services will you need? * Regular daycare Evening/weekend daycare Grooming Where did you hear about West End Tails? * Referral Internet Search Word of Mouth Walking by Other E M E R G E N C Y Please provide emergency contact information for your dog. These will only be used in case of emergency while your dog is with us. First Emergency Contact * Please provide an emergency contact we can reach in the event we cannot get in touch with you while your dog is with us. First Name Last Name First Emeregncy Contact Phone * Country (###) ### #### First Emergency Contact WhatsApp * Please confirm the WhatsApp number for your first emergency contact. Country (###) ### #### First Emergency Contact Email * Second Emergency Contact * Please provide a second emergency contact in the event we're unable to get in touch with the first. First Name Last Name Second Emeregncy Contact Phone * Country (###) ### #### Second Emergency Contact WhatsApp * Please confirm the WhatsApp number for your second emergency contact. Country (###) ### #### Veterinary Practice * Please provide your regular vet who does your routine visits, vaccinations, and emergency care. Primary Veterinarian * If you have a primary vet at your practice, please provide their name. First Name Last Name Address of Vet Practice * Address 1 Address 2 City State/Province Zip/Postal Code Country Vet Practice Phone Number * (###) ### #### Out of Hours Vet Number * (###) ### #### Out of Hours Vet * If you do not have an out of hours vet, the closest one to us is Medivet Camberwell on 02003816 1010. Do you have Pet Insurance? * Yes No M E D I C A L Veterinary Release Form During my absence, West End Tails and their staff will be caring for my dog(s). In the event of an emergency, I authorize you (the veterinarian) to administer medical treatment and I will be responsible for payment to you (veterinarian) upon my return. I, the Pet Owner, give West End Tails and their staff permission to transport my dog(s) to the vet listed above and authorise treatment in the event of an emergency or sickness. If this veterinarian is not available or outside of London Zone 2 (commuting distance from West End Tails), I authorise West End Tails and their staff to transport my dog(s) to a veterinarian of choice and authorise treatment. If emergency care is needed after regular office hours, my dog(s) may be taken to the nearest Veterinarian Emergency Clinic/Hospital. Signed: Owner's Name * First Name Last Name I give permission to West End Tails Staff to approve treatment up to (input maximum amount or no limit) * Responsibility for Charges * I agree to be responsible for all charges upon my return including, but not limited to, vet fees, medication fees, extra visit fees and transportation fee. Yes In Extreme Circumstances * I agree to authorise the veterinarian to euthanise my pet in extreme circumstances after all reasonable attempts have been made to reach me or my emergency contacts. Yes I agree that West End Tails is released from all liability related to the transportation to and from the veterinarian and treatment for sickness or emergency. This release will remain valid for all current and future visits unless a new release is signed. * Yes By writing your name here, you are agreeing to the veterinarian release and confirming you are authorised to do so. * Please add both your first and last name. First Name Last Name Dog's Medical Information Medical information must be accompanied by veterinarian records. Is your pet generally in good health? * Yes No Please include any overall health comments. * Please include any recent hospitalizations or health issues. Vaccinations Please include the most recent date of vaccination. Required Vaccinations include Leptospirosis, Adenovirus, Parovirus, Canine Distemper NB: At least two weeks must elapse after vaccination before service can commence. My dog has received all required vaccinations My dog has vaccinations scheduled Titre Test * Alternative to Vaccinations - please contact us directly to discuss. Yes No Has your dog received a Bordetella bronchiseptica/Canine parainfluenze virus vaccination (Kennel Cough)? * Yes No Is your dog up to date with worming and flea medication? * Please provide veterinary evidence. Yes No Medical Please provide the details (name/type) of any medication your pet is currently being prescribed and what condition this is for. * Write no medications if nothing taken. Does your dog have any allergies? Yes Food sensitivities No Does your dog have any mobility issues? * Yes No Does your dog have any medical conditions of which we need to be aware? * Yes No F E E D I N G Meals Please select which meals your dog eats and provide the approximate times. Morning Mid-day Evening Additional Meal Brand of food * We collect this information in the event we have your dog during a meal time and you haven't sent their food. We will make every attempt to substitute with this food or an equivalent. Quantity of food at each meal * Please be as detailed as necessary Is your dog posessive over food? * It's ok if they are! We have private dining bays that can be used! Yes - please use private dining bay No - my dog is happy to share meal times with othesr My dog isn't posessive but I prefer they eat alone Does your dog eat food very quickly? * Yes Normal pace Slow eater and prefers to nibble West End Tails serves a variety of treats/snacks as rewards and enrichment activities (i.e. LickiMats). Everything is in moderation! Please confirm which snacks your dog is allowed to have. Vegan products (incl. oat/coconut yogurt) Vegeterian products (incl. yogurt) Fish products Meat products (NO chicken) All meat products Please detail any additional feeding/snacking notes here. * B E H A V I O U R Please provide as many details as possible so that we can provide a consistent experience when they are with us. We'll also do our best to work on new tricks! Does the dog utilise a crate at all? * Please provide any specific deatils about regular crating routine. Yes - provide details No Which commands does your dog know? * Sit Stay Lie Down Walk Back Come Roll Over Spin Heel Paw/Shake Kiss Other My dog does commands tricks so well, they'd win Crufts! Please be honest! Commands (sit, stay, come, etc) Strongly Disagree Disagree Neutral Agree Strongly Agree Tricks Strongly Disagree Disagree Neutral Agree Strongly Agree Quick overview of your dog's favourite day. * Walk times, sleepy times, treat times, etc. Would you describe your dog as reactive? * Please be honest! Yes - provide details No How does your dog react to other dogs outside on-lead? * Please note that West End Tails will never let our dogs off-lead outside but we will occasionally encounter off-lead dogs in Lincoln's Inn Fields. How does your dog react to other dogs outside off-lead? * Please note that West End Tails will never let our dogs off-lead outside but we will occasionally encounter off-lead dogs in Lincoln's Inn Fields. How does your dog react to other animals on lead? * Cats, squirrels, urban foxes, pigeons, etc. How does your dog react to children outside on-lead? * Love? Hate? Please avoid! Has your dog ever snapped at a human? * Yes - please describe No Has your dog ever bitten a human? * Yes - please provide details No Does your dog suffer from separation anxiety? * Yes - mild Yes - severe Occasionally but then warms up Not at all Is your dog an aggressive chewer? This is so we know what kind of toys to provide! Yes When nervous/stressed No My dog gets along with other dogs. * West End Tails will focus on dogs under 25kg but will run into larger dogs when out for walks. Please help us anticipate how your dog will respond to both our dogs as well as those they encounter outside. Tiny dogs (ex. Teacup Yorkshire Terrier) Strongly Disagree Disagree Neutral Agree Strongly Agree Small dogs (ex. Mini Cavapoo) Strongly Disagree Disagree Neutral Agree Strongly Agree Medium Dogs (ex. Cocker Spaniel) Strongly Disagree Disagree Neutral Agree Strongly Agree Large Dogs (ex. Labrador) Strongly Disagree Disagree Neutral Agree Strongly Agree XL Dogs (ex. Great Dane) Strongly Disagree Disagree Neutral Agree Strongly Agree Short-nosed dogs (ex. French Bulldog) Strongly Disagree Disagree Neutral Agree Strongly Agree Really furry dogs (ex. Chows) Strongly Disagree Disagree Neutral Agree Strongly Agree Smiley dogs (ex. Staffordshire Terriers) Strongly Disagree Disagree Neutral Agree Strongly Agree Other Strongly Disagree Disagree Neutral Agree Strongly Agree Where does your dog like to sleep/lounge? Please check all that apply. Hard floor Dog bed Sofa Carpet Blanket/mat Other Please provide any additional information about your dog's behaviour/likes/dislikes that will help us make West End Tails a really positive environment and experience for them. * D E T A I L S Consents, permissions, and Legal Please provide your consent to all below. * I consent to my dog(s) sleeping together with dogs from other households in the same daycare space. I consent to my dog(s) playing on the premises with dogs from other households. I consent to my dog(s) being walked on-lead outside of the daycare premises with dogs from other households under the supervision of West End Tails. I consent to my dog(s) being transported for walks and any other requirements by West End Tails. I consent to my dog(s) being fed with other dogs whilst under the supervision of West End Tails. I agree to fully update you, the Service Provider prior to any future service, for any behavioural change or medical change in my pet(s) (Please note vaccinations and anti-parasite treatments must be checked before every service). I consent to the Service Provider seeking a veterinary assessment and emergency treatment, if the Service Provider deems it necessary, and for the Service Provider to administer any medicines prescribed by the veterinarian. I consent to West End Tails deciding which veterinarian is to be used. I authorise the chosen veterinarian to administer medical treatment and I will be responsible for payment to the veterinarian upon my return. I consent to the use of a crate (only if the dog is already habituated to it). I consent to the enrichment and exercise programme as agreed with West End Tails to include on-lead walks, free running inside, socialisation and play. I consent that in the event of aggressive behaviour or an emergency (i.e. a dog coming into season), I will arrange for my dog to be removed from the environment either by myself the owner, my representative or, if necessary, for the dog to be placed in alternative kennels/boarding arrangements, at my cost. I give permission for the posting of pictures and videos of my dog(s) on social media and in any promotional materials for West End Tails and any associated partners (including but not limited to LickiMat, Beco, Denzel's, etc.).. I agree that I cannot hold West End Tails responsible for loss or injury incurred (to my own dog(s) or to another animal or person) as a result, unless West End Tails is shown to be negligent. I consent that any changes that I, as the owner need to make, will be notified prior to any future bookings. By signing this form, I agree that all of the aforementioned information which I have detailed in the registration form is correct. GDPR - I have read and consent to your Privacy Policy (a copy is available on request). Terms & Conditions - I have read and consent. Signature * By adding your name here, you are consenting to and acknowleding all of the above. First Name Last Name Date of Acknowledgement * MM DD YYYY Thank you so much for registering with West End Tails. We’ll be in touch within 24 hours to discuss next steps which include a meet-and-greet trial session and access to daycare/grooming booking. N E W D O G R E G I S T R A T I O N
