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Option 1 > Fill out the form below

Customer information Medical Release

Kindly complete this form prior to booking any of our services.

This only needs to be done once. Please create an account to make future bookings even quicker!

BED BARK & BEYOND 

Holly 714-697-8016

Doggystay35@gmail.com

If your dog is showing signs or symptoms of anxiety or distress, ie.. excessive panting, whining or barking, Do you give permission for us to give them natural doggy Calming chew or oil?
Yes
No
Are Vaccinations up to date?
Yes
No

Either copy and email or please have your vet send current vaccinations to doggystay35@gmail.com

Is your dog crate trained?
Yes
No
Is your dog on flea or tick medication from the vet?
Yes
No

Prescription ( Over the counter products such as Frontline do not work here)


Feeding Instructions, Dietary restrictions, allergies etc. (please add these onto a ziplock bag with food, marked with name of pet and how much to feed per serving. Please DO NOT bring any sort of measuring cup, bowls or containers that needs to be given back; disposable only.

Primary Veterinary Information:

hereby give Bed Bark & Beyond my express permission to take my pet/s to the above – mention veterinarian or to the closest open facility if the primary vet is not available I give permission for the veterinarian to administer any care or medications necessary. I will assume full responsibility for the payment for any and all veterinary services provided.  

I am aware that given the sometimes unpredictable nature of dogs, an altercation or any unforeseen accident could occur at the daycare which may result in injury to my dog, to other dogs, or to other people. I alone assume responsibility for any such injury or unlikely occurrence to my dog regardless if another dog is at fault. Furthermore, I will not hold Bed Bark & Beyond responsible.

Date

Option 2 > Print out the form

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