Client Forms: Daycare Consent Form Find an Embassy Location Client Forms: Daycare Consent Form Find an Embassy Location Daycare Consent Form Location * - Select One -Hardin ValleyEmory RoadLenoir CityWestland DriveLand O'Lakes Owner Name * Owner Name First First Last Last Email * Phone * Medications Name * Dosage * Frequency * Last Given * plus1 ADD A MEDICATION minus1 REMOVE A MEDICATION Does your pet have any food allergies? * Yes No Are we allowed to give your pet Embassy Treats? * Yes No Food Brand * Amount Frequency of Feeding * plus1 ADD FOOD minus1 REMOVE FOOD Belongings * Emergency Contact Name * Emergency Contact Name First First Last Last Emergency Contact Phone My pet is up to date on vaccines/physical exams. * I agree I approve my pet to be scanned for a microchip. * I agree My pet has never bitten anyone/had aggressive tendencies. * I agree My pet has never bitten or had aggressive tendencies toward other animals. I agree My pet does not chew on bedding. * I agree I approve my pet to have bedding * I agree I understand that this facility is not responsible for any lost collars, bowls, toys, beds, etc. * I agree Would you like us to bathe your pet for an additional fee? * Yes No Would you like us to trim your pet's nails for an additional fee? Yes No Would you like us to express your pet's anal glands for an additional fee? Yes No Any other overall questions/concerns? Signature * signature keyboard Clear Date * Captcha SUBMIT If you are human, leave this field blank.