Dog Authorization & Services Form

This authorization grants Show Dog Synergy L.L.C. with the legal rights to have possession of and provide the necessary care for the client’s dog while in the possession of Show Dog Synergy L.L.C. It is not a conveyance of ownership and it is not a co-ownership agreement.

This authorization form also identifies the services that Show Dog Synergy L.L.C. is to provide the client during the periods specified.

If you have multiple dogs that you would like SDS to provide services for; please complete and submit a Dog Authorization & Services form for each dog.

We look forward to working with you and meeting your dog showing goals.

Entering information in this Dog Authorization form completes the SDS Dog Authorization Agreement.

By clicking the applicable check box; Client agrees that they have read and understood Show Dog Synergy's Dog Authorization Agreement and agree to comply with the terms and conditions as defined in the agreement. All services, fees, charges and payments shall be in accordance with the terms of this agreement. A copy of this form attached to the SDS Handling Agreement Terms / Conditions and the Client's SDS Customized Services Quote will be provided to the Client upon submission of this form and execution of the agreement To read the Dog Authorization & Services agreement click here . To read the SDS Handling Services Terms and Conditions click here

Note: If a copy of the dog's AKC Registration papers are provided with the dog; only enter the AKC Registration Number for the dog's Registration Information. Additionally please describe fully below any previous displays of aggression of ANY TYPE whether provoked or unprovoked that SDS should be aware of in order to protect all of our client dogs.

* identifies a required field

* I have read and understood the SDS Dog Authorization Agreement


Dog Ownership Information

	Name of Primary Owner / Client:			Name of Co-Owner: Not Applicable
*First Name:		*Home Phone:	First Name:		Home Phone:
*Last Name:		*Cell Phone:	Last Name:		Cell Phone:
*Address:		*Work Phone:	Address:		Work Phone:
		*Email:			Email:
*City:			City:
*State:		*Emergency Contact Number:	State:		Emergency Contact Number:
*Zip Code:			Zip Code:

Name of Person Authorized to Represent the Owner / Client if Non-Owner / Co-Owner or dog

	Name of Representative: Not Applicable
First Name:		Home Phone:
Last Name:		Cell Phone:
Address:		Work Phone:
		Email:
City:
State:		Emergency Contact Number:
Zip Code:

Dog Registration Information	Dog Health Information
AKC or Other Registration No:	Regular Diet:
Registration Entity:	Unique Diet Needs:
Breed:	Feeding Guidelines / Instructions:
Variety:	Chronic Illnesses:
Sex / Gender:	Other Health Issues:
Full Name:	Shot / Medication Record:
Call Name:	Rabies:	Date Given:
Date of Birth:	DHLPP:	Date Given:
Country of Origin:	"Kennel Cough" Bordatella Vaccine:	Date Given:
Tattoo or Microchip Number:	Flea & Tick Preventative:	Date Given:
Breeder:	Heartworm Preventative:	Date Given:
Sire:	Heartworm Preventative Brand:
Dam:

Dog Behavior Information			Dog's Veterinarian Contact Information
Unusual Habits: (Climbing, Digging, Etc.)			Office Name:
Precautionary Behaviors:			First Name:
People Aggression:			Last Name:
Animal Aggression:			Address:
Other Aggressions:
			City:
			State:
			Zip Code:
			Office Phone:
			Email:
			Emergency Contact Number:

Services to be Provided -

	Service	Service Dates		Show Circuit or Shows	Additional Information
	On-Line Entry	Start:	End:
	Handling	Start:	End:
	Grooming	Start:	End:
	Conditioning	Start:	End:
	Boarding and Care	Start:	End:
	Unique Health Needs	Start:	End:
	Training	Start:	End:
	Transportation	Start:	End:
	Airport Pickup	Start:	End:
	Show or Ad Photography	Start:	End:
	Special Support Services	Start:	End:

By clicking the Submit button you are acknowledging that you have read and understand the terms and conditions of the Show Dog Synergy Dog Authorization agreement. Additionally by clicking the Submit button you agree to pay the applicable fees or charges as defined and provided within the SDS Client's Customized Quote included hereto by reference and provided to Client prior to execution of this agreement. A copy of the Client's SDS customized quote, this completed Dog Authorization form and the Dog Authorization Agreement will be provided to the Client upon initial execution of this agreement.

If you prefer to print out, complete and either e-mail or mail your Dog Authorization form click here

If you prefer to complete an online PDF version of the Dog Authorization form click here