Admissions form | Chester's House and Gardens

Admission form

Owner's name, address & telephone number *

Dog's name, age & sex *

Are they neutered? Yes or no *

Is your dog unto date with their vaccinations? DHP (Distemper, Hepatitis, Parvovirus) and either L2 (Leptospirosis) or L4 (Leptospirosis) and kennel cough) We will need to see their vaccination certificate. *

Has your dog recently been treated for worms and flees? Yes or no *

Your vets name, address & telephone number *

Emergency contact's name and telephone number *

Medication & Vitamin details, please list. We ask you to leave medication clearly labelled in terms of dosage and administration *

Does your dog suffer from any illnesses (past or present) that we should know about? *

Does you dog have any phobias? *

Does you dog have any allergies or intolerances? *

Exercise Information, how many walks per day and how far shall we take your dog? *

Would you want us to exercise your dog off lead? *

Does your dog have a good level of recall and what command do you use for recall? *

Feeding. Please give name of food, details of amount and frequency. *

Do you agree to us using photos of your dog on our social media pages (Facebook & instagram) Yes or no *

Is your dog allowed healthy treats such as carrots? Yes or no *

Is your dog allowed on the sofa? Yes or no *

Is your dog microchipped? Yes or no *

Do you need us to pick up and or drop off your dog? *

Date and time of collection or drop off on admission *

Date and time of collection or drop off on your return *

Please read the terms and conditions section. Do you accept them? yes or no *

Feel free to ask any questions of tell us anything we should know *