Dog Hill

Client Reservation Form

Please complete the registration form as fully as possible, then click Submit. (*For more than one dog, please complete this form for each dog, or provide as much information as possible for all dogs.) We'll be in touch with you as soon as we can to discuss your specific dog care requirements, and how we can be of service to you.

* Required fields

Name *

E-mail Address *

Home Phone Number

Cell Phone Number

Address (street address, city, zip) *

Special Access Instructions?

Typical Work Hours

Your Dog's Name *

Gender *

Is your dog spayed or neutered? Please note that we can't care for entire males over the age of 9 months or female dogs in season. *

Size and Color *

Breed and Age *

Valid Tag or License Number

Dog has received complete immunization for DHLPP, Bordatella (Kennel Cough) and Rabies *

Is your dog continent and fully house-trained? *

Please provide details of any recent or current health problems.

If your dog is on medication, please provide details (purpose, dosage and frequency)

Is your dog insured? *

Is your dog micro-chipped? *

Has your dog ever shown aggression towards people or other animals? If yes please give details

Does anything upset, disturb or unsettle your dog? If so please give details

Does your dog enjoy grooming? *

Will your dog come back when called? *

What specific commands does your dog understand and respond to? *

Which of our services are you interested in? *

Preferred date for service / Weekly Walk Days

Preferred Time Slot

If the services, days or times you require differ from those provided, please tell us what you need

Start Date

End Date (if applicable)

Emergency contact name, address and phone number *

Vet Name, Address and Phone Number *

Any special requirements, e.g. vegetarian, male/female/couple, willing to have dogs on the bed etc.,

How did you hear about Dog Hill? *

Please expand on your previous answer if applicable, i.e. who recommended us, which directory you found us in, or where you saw our poster or flyer.

I have read, understand and accept the liability waiver, terms & conditions and release forms *