New Client Application-Dog - Luxury Unleashed LLC | Dog Boarding & Day Care In Havre

Luxury Unleashed New Client Form

Thank you for your interest in boarding your dog! Our application is quite detailed, so please allow 15-20 minutes for completion. We STRONGLY recommend that you do this from a computer rather than your phone. This information helps us to be able to provide the very best care for your furry friend! Please complete and submit one application FOR EACH DOG, and we will be in touch. **After submitting the form, look for the verification page indicating that the form has been submitted successfully.

Name(Required)

First Last

NOTE: Our facility will be completely CLOSED from July 11th through July 28th. No reservations during this time will be made.

Cell Phone(Required)

Name of Spouse/Partner

Spouse/Partner Cell Phone

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you live in the Havre area?(Required)

Yes, I live in Havre.

I am moving to Havre.

I am visiting from out of town.

I plan to travel to Havre to board my pet.

Do you text on your cell phone?(Required)

Yes I text.

No I do not text.

Home Phone (If you have one)

Email(Required)

Other than yourself, your spouse, or your vet, who would you trust with a life or death decision for your pet?(Required)

Relationship to Emergency Person:(Required)

Phone Number of Emergency Person:(Required)

How did you hear about us?(Required)

Google

I’ve been a client in the past.

Referred by a friend.

Referred by Robin at HL

Facebook

From my veterinarian.

Other

We would love to know who referred you!(Required)

Boarding Dates

Do you need to board your pet within the next 24 hours?(Required)

Yes

We need your vaccination records from your vet asap.(Required)

I will call my vet and have them emailed ([email protected]).

I want to drop off on this date:(Required)

Which is a:(Required)

Please choose a two-hour drop off window:

I want to pick up on this date:(Required)

Which is a:(Required)

Please choose your pick up window. Please note that morning pickups have changed, and now BEGIN no earlier than 11 am, so please be aware if you are picking up in the morning, your door code will not function before 11 am.

11 am to Noon (1/2 day charge)

Noon to 2 pm

2-4 pm

4-6 pm

6-8 pm

8-10 pm

10-midnight

Midnight to 2 am

Dog Details: Please note that you must fill out a SEPARATE form for EACH pet; individual forms submitted for multiple pets will not be processed. This is for insurance purposes, so we really appreciate your compliance!

Do you have more than one dog who will be staying with us?(Required)

Yes

Dog's name:(Required)

Have you ever boarded this dog before?(Required)

Yes

Have you boarded this dog with us with us in the past?(Required)

Yes

STOP! You are in the wrong place! You need to make reservations! Please go back to home page and click the box on the right that says EXISTING CLIENTS: Make or change online reservations! Please DO NOT proceed with this form! Thank you!

Got it.

Approximately how many times per year do you think you will need to board this dog?(Required)

I usually have a friend/relative take care of my pet.

This will probably be the only time I’ll need to board my pet.

Less than 5 times per year.

5-10 times per year.

On an ongoing basis.

What breed (or mixture of breeds) is your dog?(Required)

How old is your dog?(Required)

Please select:(Required)

Female Spayed

Male Neutered

My dog is too young to spay/neuter (under 1 year of age).

Other (please note that we no longer accept unaltered adult dogs.)

My dog is mostly:(Required)

an inside pet.

an outside pet.

My Dog Is:(Required)

Housebroken & rarely if ever has accidents.

Housebroken but occasionally has accidents.

Mostly outside and is not really housebroken.

Housebroken but can be a leg-lifter in new places (male dogs)!

Not really housebroken yet but is in training.

Using puppy (potty) pads.

Approximate Weight:(Required)

Do you ever take this dog to a dog park?(Required)

No I do not.

Yes I do occasionally.

We make regular visits to dog parks.

Has your dog ever jumped or climbed a fence?(Required)

Yes

Has your dog ever bitten anyone?(Required)

Yes

Please explain, in detail, the circumstances surrounding the bite:(Required)

Is your dog currently under vet care?(Required)

Yes

What is he/she being treated for?(Required)

Name of Your Current Veterinarian:(Required)

Veterinarian's Phone Number:(Required)

Does your dog require medication?(Required)

Yes

How Many Different Types of Medication Daily?(Required)

Just one medication.

Two different medications.

Three or more medications.

Please list each medication, what it is used to treat, the dosage, how many times to administer daily, and how you give it to the dog (in a piece of cheese, etc.):*(Required)

Does your dog have any health problems, allergies, or past injuries?(Required)

Yes

Please explain the medical condition, allergy, or injury:(Required)

Within the last week has this dog:(Required)

Been coughing or hacking

Had diarrhea or an upset stomach

Been scratching more than normal

Had a cut, scrape, puncture, or sore muscles, or been limping

Been treated for fleas or ticks? Or have you noticed any parasites or bugs on the pet?

Acted differently than normal? Lethargic, or low energy

My dog has been acting normally.

Please check all of the above which apply.

My dog chews:(Required)

On anything within reach!

Only on his own toys.

To get out of things, including chain link fencing!

Is your dog likely to chew up any decor in the cottages?(Required)

No, I am confident he/she will not chew on things.

I am not sure if he/she will chew! (No problem-we have comfy boarding options for those pets who like to chew on everything! No worries!)

My dog barks when:(Required)

He wants attention.

At the doorbell.

At people walking by.

At loud or strange noises.

When he is left alone.

When he is in a crate or kennel.

I use an anti-bark collar.

Rarely, if ever.

Please check all of the above which apply.

My dog shows aggression:(Required)

Around food.

Other dogs.

Around strangers.

Around children.

In his area/territorial.

When he is fearful.

Never.

Please check all above that apply.

Do you think this dog would enjoy playing with other friendly dogs in a closely-supervised play group?(Required)

Feeding

We are required to use our own food and water dishes, so please note that you will not need to bring these for your buddy’s stay with us.

What brand of food(s) do you feed this dog?(Required)

He eats:(Required)

Only dry food (kibble)

Dry food with some canned

Only canned food

I make homemade food for my pet.

How many times per day do you feed this dog?(Required)

Once Daily

Twice Daily

More than Twice Daily

Free range-I leave food out all the time, and the dog eats whenever he wants.

How much do you feed at each meal?(Required)

**With the boil-alert in affect for Havre city water, all guests will need to bring water for their pets for their stay. A $40 surcharge will be charged for guests who do not bring their own water. We HATE to do this…but thanks to the city, we have no choice. We are NOT happy about it, as I am sure you aren't either! Ugh!(Required)(Required)

I will bring water for my pet during his stay.

I refuse to bring water and would love to be charged the $40 fee. (This is the wrong answer, by the way!)

Is there anything else you would like us to know about feeding or meal times?

Fun Stuff

Please choose which boarding enclosure option you would like for your buddy:(Required)

Economy Boarding in a regular (wire) enclosure ($48 daily for one dog, $60 for two, $70 for three)

Luxury Individually-themed Cottage Boarding ($58 daily for one dog, $70 for two, $80 for three)

NEW!! Super DELUXE Cottage with a 40 sq foot additional indoor patio area! (One dog $78 per day (add $10 for each additional dog daily)

How about some extra attention for you dog while he stays with us? Each 20-minute session is just $5!(Required)

I would like to spoil my dog with 1 Fun Time daily (add’l $5 per day).

I would 2 Fun Times daily (add’l $10 per day).

I would like more information about Fun Times.

No thank you.

A Fun Time is twenty minutes of one-on-one playtime, quiet time, or even a game of fetch with your buddy! Schedule as many daily as you wish!

Got it!

Feeling guilty about leaving Fido behind? We can help! We offer several different pampering options for your best friend! Read details about packages on our SERVICES page. Each Pamper Package is $69, which includes all guests who are in the same enclosure or cottage!(Required)

For the ENERGETIC GUESTS: Super Playtime Fun Package $69

For the NERVOUS GUESTS: Comfort and Cuddle Package $69

For the PAMPERED GUESTS: Movie Night & Massage $69

No thank you.

Does your pet need any health or grooming maintenance? Maybe have his nails done or ears cleaned, etc.? Here is a list of our grooming options:*(Required)

“Pawticure”: Nail trim & file, foot massage, and pad conditioning treatment $35

Leave-in Coat Conditioning Treatment $18 Helps with excessive shedding, dry skin, and that lovely “doggy smell” too!

Ear Flush and Cleaning $18 We use a soothing, alcohol-free, botanical ear cleaner which continues to work for several days after application!

Teeth Brushing & Inspection $18 We will brush and inspect your buddy’s teeth, AND a special doggy toothbrush to take home, too!

**SPECIAL: Save $15!! Choose our Mini Spa Package for $69, which includes all of the above services!!

Infrared Massage Therapy: Shannon is certified in Reiki, which is a Japanese technique for stress reduction and relaxation that also promotes healing. $30

No thanks-all of the pampering that is already included will be just fine for my buddy!

Additional Feeding Options: We can provide enjoyable, homemade, organic treats to pamper your dog during your absence. We understand that some dogs may have difficulty eating when their owners are away, so we always have a selection of free-range chicken, grass-fed beef, lamb, wild-caught cod and salmon, as well as a variety of organic dog-friendly fruits and vegetables to encourage their appetite.(Required)

Just my dog’s regular food will be fine.

Organic, dog-safe meal enhancers (listed above) $8 per day

Spring and Summer Season: Yogurt Pupsicles $8

Fall and Winter Season: Pooch Pumpkin Pastries $8

Would you like this to be a one-time treat or a daily treat?(Required)

Just once please.

I would like my furry friend to enjoy room service daily. (We will go over exact details with you.)

Other

Vaccinations and Worming

To ensure compliance with insurance requirements, vaccination records must be submitted directly to us from the administering veterinarian's office. We are unable to accept records directly from pet owners. Please contact your veterinarian and request that a current copy of your vaccination records be emailed to us within 7 days of submitting this application. The email address to send the records to is: [email protected].(Required)

I will have the records emailed within 7 days of submitting this application..

I need to have this pet’s vaccinations updated, and will have my veterinarian email the updated records when this has been done.

For everyone's protection, ALL vaccinations must be administered AT LEAST SEVEN DAYS PRIOR to the boarding.(Required)

I understand this policy and will comply.

Please choose one:(Required)

I have my dog vaccinated by a veterinarian.

I buy the vaccine and vaccinate my dog myself.

need to have my dog’s vaccines updated.

I have my veterinarian check titers instead of vaccinating.

Exact date of last Rabies vaccination from a vet:(Required)

Exact date of last Distemper/Parvo combo vaccination from a vet:(Required)

Exact date of last Bordetella (or Kennel Cough) vaccination from a vet:(Required)

Exact date of last canine influenza vaccination from a vet (not required, but highly-encouraged):

Has your dog received deworming treatment from a veterinarian in the past six months? Regular deworming is essential for dogs, and some owners may not be aware of this. A simple call to your veterinarian can provide you with a one-time pill or powder to be mixed into your dog's food. It's a straightforward process! We emphasize this because we value your pet's ongoing health and genuinely care about our guests.(Required)

My dog is on a heart worm prevention program through my vet.

My dog has been wormed in the last six months by the vet. I will have the vet provide proof along with my vaccination records.

I will have my dog wormed, and will update you when it has been done.

Payment

PAYMENT: You will receive an online invoice for your boarding fees prior to your departure date. This invoice must be paid within three days of receipt in order to hold your boarding reservation and to avoid a late payment fee. We will issue a door code for access (you will learn more about this after your application has been approved. We will provide detailed instructions regarding access to our drop off and pick up area).(Required)

Got it.

On Drop-off Day

DROP-OFF PROCEDURES: Once your application is approved, you will receive comprehensive instructions regarding our self-drop off and pick-up procedures. Nonetheless, here are some preliminary details to bear in mind. You are encouraged to bring any items such as beds, toys, treats, and blankets that will provide comfort to your pet during their stay. We make every effort to ensure the return of these belongings as well. However, we kindly request that during drop-off, you refrain from placing anything inside the actual enclosure, except for your dog(s). This includes food and toys. There is a designated area in the drop-off zone where you can leave your pet's belongings, which will then be transferred to the cottage where your dog will be enjoying his stay with us. Kindly please initial.(Required)

FOOD CONTAINERS: Please bring ONLY enough food for your dog's visit, along with a few extra meals as a precaution. However, we kindly request that you avoid bringing the large 25+ pound plastic food buckets/containers for your dog. Instead, we recommend using Wilcoxin's Ice Cream buckets, which can be easily obtained from Gram's Ice Cream Shop downtown for $1 each. These buckets are food-safe, the ideal size (they are 2 gallon instead of those available at the grocery store), and can be reused. Additionally, please refrain from bringing your pet's dishes as we must use our own. Kindly initial below.(Required)

CHEW TOYS: Your pet's safety is our top priority during their stay with us. To ensure there are no choking hazards, we kindly request that you do not bring hard plastic chew toys, antlers, rawhide chews, or real bones. These items will not be given to your pet for safety reasons. However, non-rawhide chews, as well as Kong toys and treats, are perfectly acceptable options. You can trust that we prioritize your pet's well-being and provide them with safe and enjoyable playtime experiences. Please kindly initial to acknowledge this.(Required)

Tell us more…

As pet lovers ourselves, we understand that every dog holds a special place in their owner's heart and is deeply cherished. We are genuinely interested in learning more about your furry companion! Is there anything you haven't shared yet that you'd like us to know? We would be delighted to hear what makes your buddy uniquely special to you! Your pet's story is important to us, so please feel free to share.(Required)

Legal

GENERAL TERMS: Luxury Unleashed LLC will exercise reasonable care for the safety of your pet and to keep the boarding premises safe and secure. Luxury Unleashed LLC's liability for any boarded pet will not exceed $25. Pet owner is solely responsible for any property damage or bodily injury inflicted by the boarded animal. Luxury Unleashed LLC cannot guarantee against accidents. We will not be liable for loss or damages to pet’s belongings.(Required)

I have read the above statement, and I AGREE

I have read the above statement, and I DON’T AGREE

VACCINATIONS/HEALTH: All animals must be current on vaccines for Rabies, DHLPP and Bordetella (kennel cough). Vaccination records must be provided to Luxury Unleashed LLC DIRECTLY FROM THE VETERINARIAN prior to boarding. (Records may be emailed to [email protected]). All animals accepted for boarding must be of free of fleas and ticks; Owner will be charged a $200 fee for any animal that is dropped off with parasites, which must be paid before animal will be released. Owner hereby represents that this pet has not been exposed to Kennel Cough, Rabies, Bordetella, Distemper, or Parvo within the last 30 days.(Required)

I have read the above statement and I AGREE.

I have read the above statement and I DON’T AGREE.

BOARDING REQUIREMENTS: Owners are to provide usual food and treats. Canned food will be given upon request. If pet is trained to use training pads, these must be provided by owners. Owners may also bring treats, blankets, beds and toys if desired. We will make EVERY effort to ensure that whatever you bring with the pet will be returned.(Required)

I have read the above statement and I AGREE.

I have read the above statement and I DON’T AGREE.

MEDICATION & TREATMENT AUTHORIZATION: Prescription medications must be provided in the original container with the veterinarian’s Instructions, It will be administered as prescribed. Luxury Unleashed LLC is authorized by the owner to seek veterinary advice and care, including but not limited to emergency care, at their discretion and at the owner’s sole expense. Luxury Unleashed LLC will attempt to contact the owner before obtaining this care if possible, but this document serves as full authorization to obtain veterinary care for the pet at the owner’s expense, whether or not owner has been contacted.(Required)

I have read the above statement and I AGREE.

I have read the above statement and I DON’T AGREE.

PAYMENT TERMS: Owner agrees to pay current boarding price (as listed on website) and for all specialty services in advance. No cash refunds will be issued for any reason; boarding credit (valid for one year from issue) will be issued for cancellations with 24-hour notice. No credit will be issued for early returns or late departures. Access to pet will be denied and pet will not be released until all charges are paid in full.(Required)

I have read the above statement and I AGREE.

I have read the above statement and I DON’T AGREE.

I understand that I will be charged a DAILY RATE for boarding, NOT a nightly rate, like a hotel. I also understand that I must pay all fees online in advance.(Required)

I agree.

I do not agree.

I understand that no one besides myself or my spouse/partner is allowed in the drop-off/pick-up lounge to access my pet(s) at any time. I hereby agree that I will not give access to ANYONE ELSE, including my children (not even adult children), relatives, employees, friends, neighbors, other Luxury Unleashed LLC clients, etc.(Required)

I agree.

I do not agree.

Our insurance does not allow children to be present in the kennel nor in the play yards at any time for liability reasons. We know this can be inconvenient, and that is not our intent…we just don't want anyone to get hurt! Please initial below so that we can count on your compliance.(Required)

This contract shall be legal and binding for one year from the following date, and will include any and all boarding and/or Playcare during that period. This contract contains entire agreement, and shall be binding upon heirs, administrators, personal reps or assigns of either party. Any controversy arising from this agreement will be settled by arbitration according the Montana Arbitration Laws, with the expense of such paid by the pet owner, regardless of prevailing party. Today's date:(Required)

We take many photos of your pet(s) while he is with us, and these photos will be used for social media and marketing purposes solely at our discretion. We love sharing these photos with you, the owner as well. Please note that we retain the ownership and distribution rights to these photos. Please enter your initials below.(Required)

IMPORTANT: Please check the top of this page after hitting the SUBMIT button. If you get this error: [There was a problem with your submission. Please review the fields below.] then you will need to scroll down through the application and look for the error which will be indicated in red font. You will need to correct the problem, and hit submit once again. ****If your application has been successfully submitted, you will be taken to a confirmation page. Look for your confirmation email as well, to verigy that we have received your information. Sometimes technology fails…so, if you do not get the email, or you do not hear from us within a day, PLEASE send us an email to make sure we received the application! We appreciate all of the effort it takes to fill out this lengthy form…and we WILL respond for sure. Please type your initials below so we know that you have read this and understand!(Required)

ELECTRONIC SIGNATURE: The Electronic Signatures in Global and National Commerce Act (ESIGN) (Pub.L. 106-229, 14 Stat. 464, enacted June 30, 2000, 15 U.S.C. ch.96) is a United States federal law passed by the U.S. Congress to facilitate the use of electronic records and signatures in interstate and foreign commerce by ensuring the validity and legal effect of contracts entered into electronically. By entering my name below as an online electronic signature I understand that by doing this, I agree that this document has been signed and given the same legal status equivalent to a written signature.(Required)