THERE IS NO NEED TO DO THIS FORM UNTIL I ASK YOU TO.
DOG CARE AGREEMENT
NAME OF DOG(S):
Occupations of all Owners of the Dog(s):
Contact information for where you will be:
Who else could I contact if I can’t get you and if there’s an emergency and I can not get you?
Did you adopt your dog(s)?
Or buy from a breeder?
How old was he/she when taken from the Dog Mother?
Is he/she Neutered? Spayed? If so, at what age was this done?
Vaccinations & preventatives:
Is you dog up to date on:
Standard annual vaccinations: (DHHLP, etc) ___________
Bordetella: (kennel cough) ________________
Flea & Tick preventative? ____________
Rabies: I need a copy of the actual Rabies Certificate (not just a receipt showing you paid for the shot) If you don’t have it, have your Vet send it to me, or to you.
*** Jan 2023 The “Dog Flu” apparently now is in the Va area. https://www.washingtonian.com/2023/01/10/canine-influenza-is-on-the-rise-in-maryland-heres-what-you-can-do/
I am now strongly recommending that Guest Dogs be vaccinated for this.
There is a Bivalent Vaccine available, CIV H3N8 & CIV H3N2 Supply of it might be limited, you should check with your Vet ASAP. It’s a 2-part shot, with 2 weeks in between and there is a period after the 2nd one before the dog is fully protected… so, think about this now, rather than later.
Does your dog have any Medical Issues?
Any Skin problems?
General Care of Dog(s)
Feeding Instructions: It works best for you to just put a label or note right in with your dog’s food. So it’s where I need it, when I need it.
I normally feed two times a day.
Medications, if any, for each dog?
Special Needs, if any, for each dog?
What can I give as a Treat?
What, if anything, makes your dog(s) sick?
Any special fears or concerns? (like storms,etc)
Where do you think your dog will want to sleep at night?
About what time does she/he get up in the morning?
At Your Home:
What is your dog used to at your home?
Our Dog has the run of the house __________
Can be on furniture ___________
We have a Dog Door and fenced yard _______
He/she only goes out on leash for pottying and exercise ________
We go to the Dog Park sometimes _____________
He/She uses pee pads in the house ___________
Or a fake grass pee area _____________
We put him/her in a kennel/crate/cage:
______ at night
______ when we leave the house
Has your Dog(s) ever escaped from a fenced area? ______________
If so, what were the circumstances and what was the height of the fence?
My Fence is 6 foot tall Stockade Privacy fencing around half of the three acres and is 5½ foot tall woven wire horse-type fencing around the rest.
There is “Apron Fencing” (look it up) added to the bottom to prevent digging under.
You agree to trust this fencing and to hold me harmless should your dog(s) escape: your initials __________________
There is always the remote possibility of “acts of nature”…. a tree “could” fall on the fence, for example Note: this fencing has successfully contained many dogs of all sizes including very small and very tall.
I agree to this possible risk and hold Anna James harmless in the event my dog(s) get out. your initials __________________
Does Your Dog Come on Command? _________
If so, what word do you use? _________________________
I understand that my dog(s) will be able to play and exercise in the Smaller Separately Fenced area, (larger dogs will also get the bigger 3 acres sometimes, unless you tell me not to)
and that there is a Dog Door that gives access to this yard most of the time, to make pottying and play easy for dogs.
Anna agrees to be outside with the dogs and play with them and supervise during dedicated play times and hikes in this fenced yard a few times per day.
I, the Owner, understand that sometimes the dog(s) might go out the Dog Door for pottying or play and Anna might be in the house. If too much time goes by, I (Anna) go out and check on things. To have the freedom and pleasure of the outdoor areas, I can not be right with all dogs every minute they are outside.
You understand this system and accept the remote, but possible, risks. _______
I (Dog Parent) understand that with the fun & freedom, comes the possibilities of injury to the dog(s).
I know that the play can get intense and it’s not uncommon for a dog to possibly get nipped, or worse.
(Note: When Dogs are kept loose, living together in a regular House and Yard, and not in individual kennels, cages, runs or pens, this is called Communal Boarding. Communal Boarding is how dogs are kept when they stay with me. I do not accept any Dogs of “Fighting Breeds”; Pit Bulls, American Pit Bull Terriers, Staffordshire Terriers, American Staffordshire Terriers, Cane Corsos, Rottweilers, etc. will not be here )
I understand that injuries, disease, conditions or death could occur, and agree to hold Anna harmless if it does. ___________
I also understand that there are other potential hazards, such as: spiderbites, bee stings, stepping on a briar, scrapes, bumps, being bitten by wild animals (this would be very unusual. wild animals do not choose to come into my fence much because there are always dogs here – but I suppose the dogs “could” find an opossum or mole, or a neighborhood cat could be here.. things like that).
I understand these possibilities and I agree to hold anna harmless should any of them happen to my dog(s) ___________
First Aid: I, Anna, keep an extensive Dog first Aid Kit. I also used to be a Registered Nurse and have a BS Degree inNursing. I have the supplies and the experience to irrigate, disinfect, medicate and bandage most wounds.
I (Dog Parent) agree that for non-life-threatening injuries, it is alright with me for Anna to tend to these herself, and not take the dog to a vet.
For example; scrapes, cuts, thorn in a paw, edge of ear nipped, bites that are not life-threatening, etc. I agree to this and to hold Anna harmless for any resulting problems ______________
Emergency Veterinary Care:
Note: So far, no Guest Dog has ever had a veterinary emergency while under my care, or as result of having been in my care.
You agree to pay for any and all veterinary bills your dog may incur, regardless of how the condition/injury/disease/death came to pass. ___________
You also agree to the fact that Anna would take your dog(s) to the Veterinarian that is closest and/or the best suited for the dog and the situation.
I agree to these policies and to hold Anna harmless for any such occurrences or consequences thereof. ___________
If in Anna’s judgment, your dog requires medical attention, you, the Dog Owner, accept sole responsibility for payment of all medical bills incurred on your dog’s behalf. You release Anna James from any and all responsibility for, or claims, debts, or damages related to such medical care. ______
Should anything life-threatening occur to your dog(s), I will call you and discuss it with you.
Obviously, if it’s a life-threatening emergency, I will get the dog in my car (note: I live alone. some dogs are too heavy for me to lift them into my car, if they were so ill that they could not jump) and on the way to a vet and try to call you on the way. These policies are fine with you _______
In the event that she can not reach you, life threatening illness or injury will be treated as deemed best by Anna James within her sole discretion.
All veterinarian bills will be the responsibility of the owner, regardless of cause. ________ Owner agrees.
I try very hard to never leave home at all until a few days have passed since your Dog’s arrival and I am familiar with your dogs’ behavior and interaction with whatever other dogs may be here.
If everything is going smoothly, I would let your dog(s) have the Great Room, just like they always do, and I like to let them have the Dog Door to go out – but I definitely do not still let them have the whole three acres… that is way too much space for unsupervised dogs.
It is ok with me for Anna to go out for errands while my dog is boarded with her and Iunderstand that this is how that would be handled.
I (Anna) live alone and stay home almost all the time, but might have to run out for errands, especially if I am having your dog for a long time – obviously, I have to go out for groceries, etc. at some point.
If you tell me to isolate your dog if/when this happens, I will, wherever and however you and I agree. Example, the kitchen, the bathroom, the Foyer, or there are other possibilities too.
Instructions from you? _______________________________
I agree that this arrangement is fine with me __________
Your Dog(s) and Other Dogs:
About _________________ (Dog’s name)
___ My dog has been in situations where he/she was with other dogs, so I know how he/she behaves.
___ My dog doesn’t really have to interact with other dogs, so I really don’t know how he/she would behave.
___ I’ve never known my dog to be aggressive to other dogs at all
___ I’ve seen my dog growl and give a warning snap of the mouth to other dogs (maybe over food, toys or the other dog being too close, etc) but never any injury that broke the skin.
___ I do know of my dog having injured another dog(s), but it was an unusual situation (explain briefly) and since then, it has been ________ (amount of time) since it happened and it hasn’t happened again.
____ My dog does bite other dogs and it’s a known problem. Here’s the situation (explain)
Your Dog(s) and Other People:
Note: I live alone and I have no children. There is not much coming and going of other people here. Sometimes I do have a Worker Guy doing yard work, etc. It is not a problem if I need to not schedule him while your dog is here. If anyone else needs to come here, I can isolate your dog, if you tell me I have to. So just tell me the situation honestly, I can work with it.
____ My dog has never shown any aggression to any person
____ My dog can not be completely trusted with ____________________ (kids? Men?Anyone?)
____ My dog has a history of biting people. Give details:
Your Dog(s) and my House:
____ you can trust my dog to not destroy your house/furniture
____ you can not trust my dog to not destroy your house/furniture if you go out for errands, so you should: ________________________________________________________
_____ My dog will rip your house to shreds no matter what you do (:
Although I provide reasonable supervision and require all guests to show proof of vaccinations and flea prevention, dogs may escape, injuries may occur and fleas or disease may be transmitted.
Dog Owner agrees to hold Anna James harmless and indemnify her against all legal defense costs, fees and losses resulting from any claim made, or caused to be made against Anna James ____________________________
Your signature below indicates:
_____You have made full disclosure;
_____You have read, understand, and acceptance of the terms of this agreement
_____Your acknowledgment of the risks of Communal Boarding
This Agreement is effective and binding upon the Parties. Each time you have your dog(s) to Anna James’ residence, Wagadilly Cottage you affirm the terms of the Agreement.
Owner Signature: _____________________________________________