Day Play Authorization Form

Please fill out this form as completely and accurately as possible.

Day Play Authorization Form

It’s very important that you fill out this form preferably 48 hours prior to drop off. Every time your pet boards with us, we will need a new form filled out with the correct dates. If you have more than one pet boarding with us, you will need to fill out the form for each pet boarding. We also encourage you to call us prior to pick up to process your bill before pick up.

"*" indicates required fields

Owner's Name*

First Last

Email*

Primary Phone*

Secondary Phone

Pet's Name*

Species*

Dog

Cat

Rabbit

Bird

Other

If other, please specify

What Size is Your Pet?*

Authorized Individuals*

First Last

Primary Phone*

Country Phone Number

Email*

Emergency Contact

First Last

Primary Phone*

Country Phone Number

Does your pet have any allergies or MEDICAL CONDITIONS that you are aware of?*

Yes

Will your dog require any medications to be administered during the time he/she will be attending DayCare?*

Yes

Has your pet had any coughing, vomiting, diarrhea, or in juries in the last month?*

Yes

DayCare staff cannot administer controlled substance medications. All medications must be in original containers with clearly labeled instructions.

Have you seen any fleas on your pet?*

Yes

Is your pet on flea and tick preventative?*

Yes

Is your pet on heart worm/intestinal parasite preventative?*

Yes

Does your pet have any physical limitations?*

Yes

Does your dog require a meal during the time he/she will be attending DayCare?*

Yes

Food Options*

Kennel food (Purina EN)

Own food (Please bag food for each meal and label)

PET PROFILE

How long have you owned your dog?*

Has your dog been to a daycare before?*

Yes

Is your dog comfortable with strangers?*

Yes

My dog typically prefers dogs that are (Check all that apply):*

No preferences

Larger

Smaller

Puppies

Males

Females

My dog typically does not prefer dogs that are (Check all that apply):*

N/A

Larger

Smaller

Puppies

Males

Females

Please describe any behaviors exhibited with dogs he/she does not typically prefer:*

Does your dog have any behavior challenges? Check all that apply:*

N/A

Touch sensitivity

Mouthiness

Excessive Barking

Fence Climbing/Jumping

Coprophagia (feces eating)

Destructive Chewing

Separation Anxiety

Jumping Up

Barrier reactivity

Leash reactivity

Other

Please check any behaviors your dog has exhibited past or present:*

N/A

Growling

Lunging, snapping

Resource guarding

Bitten a person

Been in a dog fight

Injured another animal

REQUIREMENTS

Puppies must be over 12 weeks and on a vaccination program.
All dogs must have been in the home for at least two weeks prior to attending daycare.
All dogs over the age of 8 months must be spayed or neutered
All dogs require up to date vaccinations for rabies, DHLPP, and Bordetella (kennel cough). Proof of vaccination or titer testing is required.
Dogs that are currently ill or injured are not permitted at daycare. Dogs who have recovered from a communicable illness within the past 30 days must provide veterinary clearance to return to day play. Owners certify by signing this application that their dog is in good health.
If your dog incurs veterinary bills during day play you, the legal owner of the animal, must pay those bills at time of pickup. In an emergency, Kittery Animal Hospital reserves the right to administer or seek veterinary care for your dog at its discretion.
Owners certify by signing this application that their dog has no history of aggressive behaviors, threatening or harming any person or animal.
We reserve the right to refuse any dog for any reason at any time.
Pick-ups must be completed by 6:00 PM. Late fees for late pick-ups do apply at a rate of $10.00 for every 15 minutes past 6:00 PM. No exceptions.

WAIVER AND AGREEMENT

Can Kittery Animal Hospital use pictures of your pet on our social media?*

Yes, you can use my pet's photo.

No, please do not use my pet's photo.

Consent*

I have read and understand*

I hereby represent that I am the legal owner of the dog(s) described above to use the services provided by Creature Comforts Kittery Animal Hospital

Consent*

I have read and understand*

I hereby waive and release Creature Comforts Kittery Animal Hospital, it’s employees, owners and agents from any and all liability for any problems that might develop with my dog(s) including, but not limited to sickness, disease, injury, running away and death, while in attendance and participation of services provided by Creature Comforts Kittery Animal Hospital provided that reasonable care and precautions are followed.

Consent*

I have read and understand*

I understand and agree that in admitting my dog(s), Creature Comforts Kittery Animal Hospital has relied on my representation that my dog(s) is in good health and has not harmed, shown aggression or threatening behavior towards any other person or any other dog.

Consent*

I have read and understand*

I agree that my dog(s) may be videotaped, photographed and or recorded. Creature Comforts Kittery Animal Hospital shall be the exclusive owner to the results and all proceeds of such media.

Consent*

I have read and understand*

I have provided the above phone number(s) to reach me in case of emergency, or the name and phone number(s) of an alternate contact person who is able to authorize services if I cannot be reached. In the event of an illness or emergency, Creature Comforts Kittery Animal Hospital will attempt to contact me or my alternate contact at the phone number(s) provided; however, I understand that if I cannot be reached within a reasonable length of time, I authorize Creature Comforts Kittery Animal Hospital to treat my pet however is deemed necessary for his/her health and well-being, and I agree to pay for any and all expenses that may be incurred.

Signature*

Your Name
Your Name
Your Name

By submitting this form, you acknowledge that you have read and agree to our Privacy Policy.

Contact Us

It is our mission to make every client and their pet feel comfortable from the moment they walk through the door.

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Address

195 State Rd. Kittery, ME 03904

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Hours

Mon: 8:00 am - 6:00 pm
Tue: 8:00 am - 6:00 pm
Wed: 8:00 am - 5:00 pm
Thur: 8:00 am - 6:00 pm
Fri: 8:00 am - 6:00 pm
Sat: 8:00 am - 2:00 pm (Appointments Only)
Sun: Closed

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Contact

P: (207) 439-4158
F: (207) 438-9155
E: [email protected]
Text Us Via PetDesk: (207) 569-3798