Pricing & Hours
3822 Airport Blvd
Austin, TX 78722
Please take a few minutes to complete this Pet Profile form (one per pet please). Please click on "Submit" at the end of this form. It will help us understand your pet’s background, personality and special needs so we can make his/her visit at Jackie's Play & Stay as safe and as comfortable as possible. Thank you for your time and cooperation.
How did you hear about Jackie's Play & Stay daycare?
If you came to Jackie's Play & Stay via a referral, who referred you?
You are interested in:
Check all that apply.
What date would you like to bring your dog in for their 1st daycare visit?
Address Line 2
District of Columbia
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
We will not supply your address to others.
Emergency Contact Name 1
Emergency Contact Phone 1
Emergency Contact Name 2
Emergency Contact Phone 2
Primary Breed - (photo may be required)
Approximate Weight (8lb minimum)
Name of Vet Clinic (where vaccinations were last given)
Phone of Vet Clinic
Yearly Heartworm Test given?
Flea and Tick Medication used?
What brand of preventative?
List any known allergies (to foods, medications or other):
Describe any health/medical issues we need to be aware of (i.e. hip problems, seizures, etc):
Are there any restrictions on your dog's activities or movements?
Does your dog take any medications?
Name of medication and for what?
Has your dog ever been boarded before?
Please describe your dog's experience:
Has your dog had any obedience training?
How long has your dog been in your family?
If adopted or rescued within the past 8 months, do you have any knowledge of your dog's past history?
Rate your dog's energy level
Does your dog play with other dogs on a regular basis?
Would you say he/she plays nicely?
Comments about this behavior:
Does your dog go to an off-leash park?
How does he/she behave there?
Does your dog bark a lot?
List any special commands to stop the barking.
Is your dog fearful of storms?
What do you recommend we do to best comfort him/her?
Is your dog frightened by anything else? Any noises?
What is he/she fearful of?
Does your dog have separation anxiety?
Please describe the anxiety/behavior.
Does your dog defecate or vomit while riding in the car?
Has your dog ever climbed or jumped a fence?
Height of fence:
Check all situations where your dog may become unfriendly:
Removing from furniture
Touching while sleeping
Another dog runs up to him
Another dog sniffs his butt
Please describe the "other" situation:
Has your dog ever growled or snapped at any person who has touched his bones or food?
Has your dog ever growled or snapped at any person who has touched his toys?
Will your dog nicely share toys with other dogs?
Does your dog automatically dislike any specific kind of dog?
(i.e. tails curled up over back; small dogs; certain breed; etc)
How does your dog react to puppies?
How does your dog react to strange people?
Does your dog automatically dislike or respond negatively to any type of person?
(i.e. men with beards; children; etc)
Has your dog ever bitten a human?
Has your dog ever bitten another animal?
Please explain the circumstances of the biting incident(s):
Does your dog use a crate at home?
If answered "no", does your dog have any known severe anxieties or fears of a crate?
Check all behaviors that apply to your dog:
Mouthiness (play biting humans)
Doesn't come when called
Aggressive on leash (lunges and/or snarls at dogs when on leash)
All materials copyright 2012 Jackie’s Play & Stay.
Web Site by