Pet Au Pair Daycare & Boarding Profile and Vet Release
NOTICE
Filling out our profile is not a guarantee of a boarding or daycare reservation.  We will contact you via email or phone to discuss further steps.  Evaluations are always required for new customers.
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Your Pet
Pet Name *
We do require that a separate profile be completed for each pet.  After hitting submit for the first form, use your Back button on your browser to go back, and most of your information will remain for the next pet.
Pet Origin
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Services Required *
Required
Dates that Services are Required *
Boarding and Daycare Evaluation *
All dogs require an evaluation by our trainer for placement into daycare or for boarding, please choose a time/day below for your free 1/2 day of daycare for our evaluation purposes.
Required
Date for Evaluation *
Give us some possible dates that you'd like to do your evaluation
Pet Color
Tell us the main color of your pet.
Pet Breed
Weight of your pet *
Date of birth for your dog ? *
Please put down the date, or approximate date of birth for your dog
Sex *
Microchip, Missoula City License Number,  ID Tag, or Tattoo Number *
Check the box for the correct option, then check Other and enter the license or ID number.
Required
Owner Information
Owner First Name *
Owner Last Name *
Street Address *
City *
State *
Zip code *
Telephone Number *
Mobile Phone Number
Owner Email *
Vaccinations / Health
Vaccinations, dates and types- We must have the dates of your dogs' last vaccination. *
Please tell us if all applicable vaccinations and licenses are current, as required by Missoula.  PUPPIES:  In addition to all regular puppy shots, puppies must have had the Bordetella vaccine for at least 14 days prior to coming to our facility.
Bordetella Vaccine *
Bordetella vaccine must have been given at least 7 days prior to coming to our facility.
Overall Health *
Please tell us about your pets overall health and physical condition.
Fears, Phobias, and Reactions
Pet Personality *
Tell us how you perceive your pets' personality most of the time.  Check all that apply.
Required
Separation Anxiety *
It is very important that you are honest with us if your pet has separation anxiety, OR needs to be around people constantly.  An anxious dog can be a destructive dog and harm themselves or others.  Check all that apply.
Required
Boarding Experience *
It is very important that you are honest with us if your pet has never been boarded, doesn't board well, or becomes destructive.
Required
Daycare Experience *
It is very important that you are honest with us if your pet has never been to daycare before, has been reprimaded, or dismissed from a previous facility.
Required
Reaction to People
On a scale from 0 to 10, with 0 being none, and 10 being very fearful, tell us how your pet reacts to people.
No fear
Very Fearful
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Reaction to other animals/dogs
On a scale from 0 to 10, with 0 being none, and 10 being very fearful, tell us how your pet reacts to other animals and dogs.
No Fear
Very Fearful
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Aggression towards animals
On a scale from 0 to 10, with 0 being none, and 10 being very aggressive, tell us if your pet is aggressive towards other animals
No aggression
Very aggressive
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Aggression towards people
On a scale from 0 to 10, with 0 being none, and 10 being very aggressive, tell us if your pet is aggressive towards people
No aggression
Very aggressive
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Other fears, phobias, etc.
Please tell us if you pet has any other fears or phobias (i.e., storms, collar, noise) that we should know about
Meals and Meds
Treats
Please tell us if allow treats to be feed during walks, exercise, etc.
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Meals *
Please list the amounts of food per meal, the type of food, and anything else you want us to know for mealtimes. We recommend, but do not require that you provide us with your pets meals. However, for services where you ask that we provide meals, we feed our grain free house food (Taste of the Wild) for $2 each meal.
Allergies/Dietary concerns
Please discuss in detail any allergies or dietary concerns that your pet may have.
Playtime
Medications/Treatments
Please discuss in detail, the medications, ointments, and treatments your pet receives.  If more than one of your pets receives medications, please mark the appropriate containers with their name.
Exercise/Activity
Tell us about the exercise or activity you would like your pet to have while you're away.  If you want your pet to have offsite hikes or walks, this is an extra charge.
Tell us things your pet loves
Tell us what play time, toys, activities, and friends your pet loves.
Anything else we need to know about your pet ?
Tell us anything you want us to know about your pet here.
Cleaning and Care
Tell us what we need to know if there are any special routines, or cleaning and care areas on your pet.  Please also tell us about  any unusual possible behaviors like vomiting, defecating or urinating in the home, drinking water excessively, possible chewing or damage, etc.
My pet might exhibit the following checked behaviors while at your center. *
If you check any of the boxes, please elaborate under "Other".  If you believe your pup may require tranquilizers/meds for their stay with us, please contact your vet and obtain these before your visit.
Required
House training *
If you check any of the boxes, please elaborate under "Other".
Required
Kennel or crate behavior *
Tell us about your dogs habits when crated/kenneled, or in any confined space, i.e. suites, locked rooms, etc.
Required
Feces behavior *
Please let us know if you dog tends to eat other dogs' feces.
Environmental Factors
Is your pet sensitive and/or reactive to any of the following: *
Check all that apply.
Required
Has your dog ever marked indoors?   *
Please be truthful, our center is very "home" like, and if your dog is a marker, we need to know, so we can put them in a belly band and avoid lots of clean-up!
Required
DIGGING - Has your dog ever dug outside?   *
Please be truthful, our yards have a sprinkler system, and digging up the heads or lines will be very expensive to fix, and result in your dog being dismissed from daycare.
Required
BARKING- Does your dog bark ?   *
Please be truthful, dogs that bark incessantly cause all the other dogs to be nervous, and in some cases, can cause fights.  Barking that doesn't respond to correction methods will result in your dog being dismissed from daycare.
Required
Pet environment
Does your pet reside primarily indoors or outdoors ?
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Are there areas in your home or yard that your pet is not allowed? *
Knowing how your dog is normally restricted helps us manage them; If answered yes, please tell us where, and why.
Control/Correction Methods you allow during Daycare *
We may find it necessary to correct excessive barking or agitated behavior, as this behavior stresses the other dogs.  We will remove a dog to time out first, but sometimes mild correction is needed before returning a dog to play.  Please check any of the methods you are comfortable with our trainer using.
Required
Emergency Contact and Veterinarian Information
Vet for your Pets *
Please enter the name and telephone number of your veterinarian.  If you don't have a current local vet, we still need the name and number of your previous vet to be able to verify vaccines, thank you!  Need a vet ?  We recommend Dr. Greg Hanich or Dr. Bill Duncan at The Animal Clinic, 406-728-6900.
Emergency Contact for your Pets, or alternate care provider *
Please give us the name of an emergency contact for the care of your pets, just in case things don't work out at our center, we will always call you first!
Disclosure and Verification
B. Has your pet ever: *
Check as many as apply, and if any are checked, please check and elaborate under "Other".
Required
I, the owner of the above listed pet, hold PAP harmless if my pet exhibits any of the above listed behaviors in item B.    I further agree to participate in the solution and/or resolution of any situation that arises from my pet exhibiting any of the above behaviors, including a financial or legal solution.  I agree to pay any citations, should they arise. *
I further understand that being around dogs that are not my own, presents a risk.  I release Emily Kirkley, and PAP from any liability when I am on premises, and in the presence of dogs.  I understand and accept responsibility for my own safety when I am in the daycare and training areas.
Conditions of Refusal of Service *
I understand that PAP doesn't allow excessive barking, digging, destructive, or damaging behaviors, and if my dog exhibits any of these behaviors, that they will consult with me on correction methods.  I understand that if I do not allow any corrections to be made, that PAP has the right to refuse service.  I understand that even if corrections and remedies are applied and my dog continues to cause a disturbance, that Emily Kirkley/PAP may refuse service.
Vet Release Information *
I understand the mission of Emily Kirkley/ Pet Au Pair (hereafter referred to as PAP) is to care for all dogs in its custody with diligence, care, love and respect; and to maintain for those dogs a healthy environment focusing on exercise and obedience.   VETERINARIAN LIABILITY AND CARE. I agree to allow Emily Kirkley/PAP to obtain medical treatment for my dog, if, after making its best efforts to contact and consult with me, in its sole discretion it appears that, he/she is ill, injured or exhibits any other behavior that would reasonably suggest that my dog may need medical treatment.  I AGREE THAT I AM FULLY RESPONSIBLE FOR THE COST OF ANY SUCH MEDICAL TREATMENT, AND FOR THE COST OF ANY TRANSPORTATION FOR THE PURPOSES OF SUCH TREATMENT, PROVIDED TO MY DOG.  I acknowledge and agree that Dr. Greg Hanich at The Animal Clinic, 406-728-6900, may be the veterinarian of choice by PAP, should my designated veterinarian is not available, to provide such care and further authorize my primary veterinarian to release and provide to PAP and Dr. Hanich all necessary medical records and information that may be necessary for such care.  
Authorization for Treatment - Type Name and Date to Electronically Sign *
I understand that Emily Kirkley/PAP may need to obtain medical care for my pet, and I expressly agree and allow PAP to obtain this care on my behalf.
I acknowledge that I have voluntarily applied to enter my dog into boarding and/or daycare sessions and activities with Emily Kirkley/ Pet Au Pair. *
I understand that even with proper care and supervision dogs can be injured, can die or run away. If while in the custody of Emily Kirkley/ PAP my pet is injured, dies or runs away, I waive any claim against PAP or its owners, employees or other agents for any claims, damages or other liability based upon that injury, death or escape.   I understand that even with proper care and supervision a dog can injure another dog or person or can damage property. If while in the custody of Emily Kirkley/ PAP my pet injures another dog or person or damages property, I will indemnify Emily Kirkley/PAP, its owners and employees or other agents from any claims, damages or other liability based upon that injury or damage.   I also understand that should my dog become destructive, a nuisance, uncontrollable, or become stressed while in the custody of PAP, that they and their employees can refuse service.   I have read this Certification, fully understand its meaning and agree to my commitments in the Certification as a condition to Emily Kirkley/PAP's acceptance of my pet in its custody.
Late Fees and Boarding Cancellation Policy *
Late fees are as follows:  If you pickup between 1-20 minutes late (after regular closing time for that day), the late fee is $5.00. 21-40 minutes late results in a late fee of $7.50, and 41-60 minutes late the fee is $10. After an hour late, you are charged the $35.00 boarding fee.  PAP boarding clients checking out prior to 10:00 a.m. on weekdays, and 11:00 a.m. on weekends, will not be charged for daycare. If checkout is after these times, you will be charged for daycare.   Cancellation  Policy- Cancellations for boarding; Reservations made less than 3 days from scheduled check-in date are final as of 6:00 p.m. on the day they were made.  Cancellations for boarding  with less than a 72 hour notice will be charged the full fee for the first day, and 40% for the remainder of their dog's reserved stay.  Holiday Boarding Cancellations - When making your dog boarding reservations during any national recognized holiday please be advised that 50% non-refundable deposit is required to book your reservation. If holiday reservations are cancelled less than 14 days of scheduled arrival date the full balance of the reservation will be charged in its entirety.  
Boarding Concerns *
Please know that it is imperative that your dog be happy, calm and stable when boarding at our facility.  If a dog seems stressed, even after initially passing the evaluation, we will call you to discuss.  We'll talk about possible solutions and measures, and if none of these tactics work to calm the dog, we will ask that someone come and get your pup.  We understand that this may not be possible, and we will take your situation into consideration.  But our main concern is your dog, and their mental and physical health.  We want to make sure we don't allow behavior to escalate into destructive behavior or a traumatizing experience.
Verification of Form *
I, the owner of the above listed pet warrant that the information contained herein is true and correct to the best of my knowledge.  If any of the information is found to be untrue, I accept all responsibility of the consequences.  I also affirm that I understand Emily Kirkley/PAP policies as stated here, and on the website.  I understand that Emily Kirkley/ PAP has the right to refuse service, before or during my reservation if my pet is exhibiting scared or panic type behaviors, or becomes a nuisance to the other dogs.
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