Off-Leash Play Application

We love dogs and want your dog to love coming to our off-leash playgroup. No one knows your dog better than you, so we'd appreciate you taking the time to fill out this application. We do understand that some questions do not apply due to your dog's age or if they have an unknown history. We ask that questions be filled out to the best of your knowledge. The more we know about the dogs in our care, the better our playgroups will be.

First name

Last name

Phone

How Did You Hear About Us?

Intro Questions

What type of socialization are you expecting for your dog? (Please select all that apply)

Engaging with other dogs (ex. Running, wrestling, neck biting)

Engaging with other dogs (ex. Just being around other dogs, observing)

Energy outlet

Training

Mental Enrichment

Build confidence around people and/or dogs

Separation Anxiety

Other: please explain

Why do you want your dog to participate in our off-leash playgroup?

What are your expectations for your dog while in daycare?

Dogs play with their mouths and paws, it is not unusual to have scrapes. Even in supervised play a dog can have a bad moment that results in a puncture wound in another dog. How would you react if your dog received a minor injury of this type?

Dog Information

Please submit one application for each dog who you would like to have in off-leash play

Dog's Name

Breed

Date of Birth

Spayed or Neutered

What knowledge do you have of your dog's past history?

Why are you considering our off-leash play program for your dog? (check all that apply)

Which of the following best describes your dog's level of socialization with other dogs?

None - No knowledge of other dog interactions

Minimal - On leash encounters only

Moderate - some off-leash play on occasion with visitor's/neighbor's/friend's dog(s)

Extensive - Regular visits to dog social events, off-leash dog parks, dog daycare, etc.

Has your dog had any problems previously in an off-leash social environment?

Yes

Altercation or fight at a public dog park

Altercation or fight with a neighbor or friend's dog

Fearful reaction in a group of dogs

Dismissed from a prior dog daycare or social playgroup program (*complete next section)

Other: please explain

*Only complete if you answered yes that your dog was dismissed from a prior program. What reason were you given as to why your dog was dismissed? Check each statement below that applies to the situation that resulted in your dog's dismissal.

My dog was injured, no medical treatment required

My dog was injured and required medical treatment

Another dog was injured, no medical treatment required

Another dog was injured and required medical treatment

A person was injured, no medical treatment required

A person was injured and required medical treatment

Provide any other comments you want us to know about for this situation.

Health History

*Please note that flea/tick collars will be removed while your dog is in daycare. After applying topical preventative we ask that you wait 72 hours before bringing your dog into daycare.

Does your dog have any allergies? If yes, please explain:

Does your dog have any physical disabilities? If yes, please explain disability ad cause:

If answered yes, what restrictions need to be placed on your dog's activities or momvements?

Does your dog have any medical conditions? If yes, please explain. If medication is used to control the condition, please provide name and dosage.

On what type of surface does your dog generally go to the bathroom (ex. grass, pee pads)?

Does your dog have any bathroom-related issues or concerns? If so, please explain:

Does your dog have any sensitive areas on their body? If yes, please explain:

Does your dog have any favorite pettings spots?

How frequently is your dog walked outside? How long are your walks?

Check the boxes below that best represents your dog's overall level of exercise routine.

Couch Potato - Spends days sleeping, occasional walks and/or playtime with humans or other dogs.

Mild Exerciser - Short daily walk and/or regular playtime with human or other dogs.

Moderate Exerciser - Long or multiple walks daily and/or regular playtime with human or other dogs.

Athlete - Regular jogs/runs and/or regular participation in a dog sport activity such as agility, flyball, frisbee, etc.

Household Information

How many dogs do you have in your household, what are their ages, breeds, and genders? Are they spayed or neutered?

Do any visitors bring their dog(s) to your house? If yes how do they get along?

How does your dog react to a stranger coming into your home or yard?

Are there any type and/or breeds of dogs your dog seems to automatically fear or dislike? If yes, please describe:

How does your dog react to puppies?

How does your dog react to another dog approaching him/her in a park or on a walk? Please answer for on leash and off of leash?

Does your dog play with other dogs?

Yes

If yes, which type?

Males and females

Males only

Females only

What kinds of games does your dog play with other dogs?

What kinds of games does your dog play with people?

How did your dog get his/her obedience training? (please check all that apply)

Dog was sent to a board and train program

Attended one group class

Attended more than one level of group classes (beginner & intermediate, etc.)

Private session in home

Other: please exlain

Which of the following best describes the use of obedience cues with your dog at home?

Has your dog ever gotten away from someone when out for a walk? If yes, please explain the circumstances?

Where does your dog sleep?

Inside the house

Outside the house

Inside/Outside - varies

If your dog sleeps inside where does he/she sleep?

Crate

Owner's bed

Dog cushion/bed on floor

Other: please explain

Has your dog ever jumped up on someone? If yes, what were the circumstances?

How does your dog act when you get home at the end of the day?

What does your dog do to show he/she is happy?

What does your dog do to show he/she is upset?

Is your dog allowed on the furniture at home?

Yes

Does your dog have any problems in any of the following areas: Mouthing, house-training, barking, digging, ignoring commands, etc. If yes, please explain:

Dog Behavior Information

Are there any particular types of people your dog seems to automatically fear or dislike?

Has your dog ever growled at someone? If yes, what were the circumstances and how did you respond?

Has your dog ever bitten a person? If yes, what were the circumstances and how did you respond? Please describe injuries if there were any:

Has your dog ever bitten another animal? If yes, what were the circumstances and how did you respond? Please describe injuries if there were any:

To the best of your knowledge, what does your dog do when you're not at home?

Has your dog ever climbed/jumped a fence? If yes, what were the circumstances? How high was the fence?

Has your dog ever escaped from your house or yard? If yes, please explain the circumstances:

How would you describe the energy level of your dog?

Low

Medium

High

Has your dog ever chased or tried to chase a small animal? If yes, what were the circumstances?

Does your dog charge the fence when people and/or other animals walk by? If yes, do you take actions to prevent it?

Is your dog frightened by thunderstorms? If yes, describe typical behavior and what specifically helps to relax your dog or calm his/her fear?

Does your dog play with any toys? If yes, what kinds of toys does your dog like?

Has your dog ever growled or snapped at a person who has taken food or toys away from him/her? If yes, what were the circumstances and how did you respond?

Has your dog ever growled or snapped at another dog who has taken food or toys away from him/her? If yes, what were the circumstances and how did you respond?

Have you ever noticed your dog stopping and staring at another animal? If yes, what were the circumstances?

Other comments or information about your dog that you feel might be helpful?

*By signing this you understand that you must provide physical proof of your dog's vaccinations; Rabies (as required by Montana State Law), Distemper/Parvo, and Bordetella Intranasal. If your dog has had their Bordetella vaccination as an injectable or oral we require them to have the intranasal 6 months after the original date it was given. Yearly dewormer is recommended but not required.

**Please bring physical proof of vaccinations on the day of your evaluation

My dog is current on Rabies

My dog is current on Distemper/Parvo

My dog is current on Bordetella

Signature

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Please look in your email for our replay (also check your spam folder). It is easier to get your dog set up for our classes this way. Also, we ask for at least 1-2 business days for our reply. We appreciate your patience!

We do evaluations Monday-Friday 10am-4pm. Once scheduled, you will drop your dog off at the set time.

What is the best time for you to drop your dog off for their evaluation?

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