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Golden Oldies Care
Home
Services
Home Boarding
Dog Adventures
Day Care
Specialist Puppy Care
Pop-in Visits
Golden Oldies Care
Meet Us
FAQ
Contact Us
Community
Please complete the form below
Days required
Monday
Tuesday
Wednesday
Thursday
Friday
Ad hoc basis
* Visits / walks take place between 10am - 3pm, Monday to Friday. * You will be notified of my arrival. * Your dogs welfare is top priority. If weather conditions are deemed to to be too dangerous, walk times may be moved or cancelled. In the event of a cancelled walk, a visit will take place instead. You will be notified in advance.
Your Details
Name
*
First Name
Last Name
Address (in Postcode)
Home Phone No.
Mobile Phone No.
Work Phone No.
Email
*
Alternative Contact Details
Name
First Name
Last Name
Relationship To Client
Address (inc Postcode)
Home Phone No.
Mobile Phone No.
Work Phone No.
Emergency Contact
Name Of Vet Practice Registered
Address (inc Postcode)
Contact Phone No.
About Your Dog(s)
Dog 1
Dogs name
Date Of Birth (If known)
MM
DD
YYYY
Breed
Sex
Male
Female
Colouring/ unique characteristics
Vaccinated/ Titre Tested
Yes
No
Date of last vaccination/ titre test
MM
DD
YYYY
Date of last Worming Treatment
MM
DD
YYYY
Date of last Flea Treatment
MM
DD
YYYY
Neatured
Yes
No
Insurance
Yes
No
Microchip Number
Any known health issues/ allergies
Please state if your dog is on any medication
Any known behavioural issues/ requirements
How Is Your Dogs Recall?
VERY GOOD (responds and recalls quickly in most situations)
GOOD (comes back most of the time)
MODERATE (can take a while to respond but recalls eventually)
POOR (doesn't respond)
Any further information which may be useful?
Dog 2
Please skip if not applicable.
Dogs name
Date Of Birth (If Known)
MM
DD
YYYY
Breed
Sex
Male
Female
Colouring/ unique characteristics
Vaccinated/ Titre Tested
Yes
No
Date of last vaccination/ titre test
MM
DD
YYYY
Date of latest Worming Treatment
MM
DD
YYYY
Date of latest Flea Treatment
MM
DD
YYYY
Neautred
Yes
No
Insurance
Yes
No
Microchip Number
Any known health issues/ allergies
Please state if your dog is on any medication
Any known behavioural issues/ requirements
How is your dogs recall?
VERY GOOD (responds and recalls quickly in most situations)
GOOD (comes back most of the time)
MODERATE (can take a while to respond but recalls eventually)
POOR (doesn't respond)
Any further useful information
TICK BOX TO CONFIRM THE FOLLOWING
Emergency First Aid Permission
By ticking this box, I hearby give my permission to allow Geopaw Premium to carry out any emergency first aid procedures as deemed necessary for the safety & welfare of my dog(s) prior to immediate consultation by a veterinary professional in order that they receive the best and most appropriate care as soon as possible. I also give my permission for my dog(s) to be given any drug prescribed by my vet as required in my absence, & agree that I have confirmed with them that Piriton antihistamine may be administered safely for the treatment of allergic reactions.
Off Lead Permission
*New dogs may be kept on lead or a long training line. This allows me to assess your dogs recall and also interaction with the group. There is always the possability your dog may not fit into the group, in such circumstances your dog will have a solo walk.
By ticking this box, I allow my dog(s) to be let off lead.*
It is mandatory for all dogs to wear a harness whilst on walks. This takes away any strain/ pressure from the fragile neck area. Collars can be worn but only for ID tag purposes.
Key Security
I release my house key(s) to Geopaw Premium for the duration of the contract. I may revoke this release at anytime and expect my keys to be returned to me immediately upon such revocation. Whilst my key(s) are in possession of Geopaw Premium, they will be kept in a safe, labelled with the name of my pet, so no address can be tracked.
Photography / Video
I hereby grant & authorise Geopaw Premium the right to take, edit, alter, copy, exhbit, publish, distribute, & make use of any & all pictures & video taken of my dog(s). To be potentially used in and/or for any lawful promotional materials including, by not limited to: flyers, posters, social networking sites, website and other print and digital communications without payment or any other consideration.
Cancellation Notice
A minimum of 24 hours cancellation notice is required, except in cases of extreme emergency. Cancellations made within 24 hours will be charged at the full rate.
I Understand
Terms & Conditions
*
You will present your dog(s) for walking in a clean and groomed condition and with up to date vaccinations/ titer test, de-flea and anti-worming treatments. .Any dog(s) joining GEOPAW Premium walks will have a trial introduction period. This will include being on lead or a long training line. This allows us to assess your dog and how they respond to us as well as other dogs in the group. No dog(s) will be accepted without a current vaccination or titer testing certificate. You agree that if you instruct GEOPAW Premium to exercise your dog off the lead you accept full liability for any loss or damage caused as a result of your dog being off the lead. In the event that your dog attacks a person or a dog or in the event that he/she is involved in a fight with another dog/person causing any damage or injury you agree to be responsible for any losses incurred including payment of veterinary fees or any medical treatment required. We are unable to accept any dog subject to the terms of the Dangerous Dogs Act 1991 or any other dogs with aggression problems towards other dogs and/or people. Reasonable efforts will be made to contact you in the event of an emergency. However, GEOPAW Premium reserves the right to make decisions regarding your dog’s health provided it is at all times acting in the best interests of the dog(s) and on the advice of a veterinary surgeon. If your dog(s) becomes unwell, has an accident or injures himself/herself or seems to be in any type of pain, we might need to take him/her to a veterinary surgeon and you agree to be responsible for payment of all the veterinarian fees incurred. GEOPAW Premium will attempt to take your dog to your own vets, however, if this is not possible, our primary local vets will be used. You undertake to make full disclosure of any quality or characteristic which might make your dog not suitable for dog walking, including, but not limited to behavioural or health problems, anti-social behaviour including aggression, incontinence or excessive loud barking/whining. Failure on your part to disclose any matter which might render the dog unsuitable for walking and will be deemed a material omission amounting to a fundamental breach of this agreement. You will also be liable for additional costs if GEOPAW Premium experiences difficulties due to failure to disclose in the booking form any matter that would be accepted as reasonably unsuitable for walking. Geopaw Premium promotes & practices modern positive reinforcement, force free training methods. We will never in any case use or recommend the use of any adverse methods or tools such as e-collars, prong collars, choke chains, slip leads etc. I confirm that I am the owner of the above mentioned dog. I have understood and agree to the above terms and conditions. I also confirm that the information supplied is correct and that any additional information that GEOPAW Premium should be aware of is also supplied and GEOPAW Premium will be made aware of any changes.
I agree to terms & conditions
Thank you!