Welcome
This intake form takes 10–15 minutes. Your progress saves automatically.
Before You Begin
Have these ready:
- Your dog's current vaccination records (photo or PDF)
- Your veterinarian's name and phone
- Two emergency contacts
- Chicago dog license number (MCC § 7-12-140)
- Microchip number if applicable
Vaccination Records
Upload your dog's most recent vaccination records. We'll auto-fill the dates.
Upload Vaccination Record
Can't Upload Now?
Provide your email and we'll send you a secure link to upload later. Note: services cannot begin until records are received.
Client Intake & Service Agreement
Please read carefully. You are giving up substantial legal rights by signing.
This Agreement is entered into between Sound Mind K9 LLC ("SMK9," "we," or "us") and the undersigned dog owner or authorized agent ("Owner," "you") and applies to all services provided by SMK9, including but not limited to boarding, daycare, behavior modification training, walk training, dog walking, and pickup or drop-off transportation. Please read carefully — you are giving up substantial legal rights by signing this Agreement.
1. ASSUMPTION OF RISK
Owner acknowledges that participation in any dog-related activity carries inherent risks that cannot be eliminated regardless of the care taken. These risks include, but are not limited to: (a) bites, scratches, punctures, sprains, or other injuries arising from interaction with other dogs or unfamiliar people; (b) escape, loss, or death of the dog; (c) transmission of contagious illness, including but not limited to kennel cough, canine influenza (H3N2/H3N8), parvovirus, leptospirosis, giardia, and ringworm, even when all required vaccinations are current; (d) stress-related conditions such as gastrointestinal upset, weight loss, or temporary behavioral change; (e) injury related to existing medical or orthopedic conditions; and (f) unforeseen environmental events including fire, weather, power loss, or acts of God. Owner voluntarily and knowingly assumes all such risks.
2. HEALTH & VACCINATION REQUIREMENTS
Owner represents and warrants that the dog is in good health, has not exhibited symptoms of communicable illness within thirty (30) days prior to drop-off, and is current on all vaccinations listed below. Written proof from a licensed veterinarian must be on file before services begin, consistent with Ill. Admin. Code tit. 8, § 25.120(b) and Chicago Municipal Code § 7-12-200 (rabies vaccination by an Illinois-licensed veterinarian, every three years or as otherwise required by the Illinois Department of Agriculture). SMK9 reserves the right to refuse service to any dog without verified records.
Spay / neuter: Dogs participating in group play must be spayed or neutered if seven (7) months of age or older, consistent with industry standard practice. Intact dogs may be accepted for boarding in single-dog accommodation only.
Chicago dog license: Pursuant to Chicago Municipal Code § 7-12-140, the owner of any dog four (4) months of age or older residing in Chicago must hold a current city dog license. Owner agrees to provide the city license number on the intake form and to keep the license current for the duration of services.
3. VETERINARY CARE AUTHORIZATION
If, in the sole judgment of SMK9 staff, the dog requires veterinary attention, Owner authorizes SMK9 and its agents to obtain such care from any licensed veterinary professional, including transport off-site if necessary. SMK9 will make reasonable efforts to contact Owner or the listed emergency contact before treatment is initiated, except where in SMK9's judgment delay would endanger the dog. Owner is solely responsible for all veterinary, transport, and related costs, regardless of cause, and authorizes SMK9 to charge such costs to the payment method on file.
4. RELEASE, WAIVER & INDEMNIFICATION
Owner hereby releases, waives, discharges, and agrees to hold harmless SMK9, its members, officers, employees, contractors, and agents (collectively, "Released Parties") from any and all claims, demands, actions, causes of action, costs, expenses (including reasonable attorneys' fees), and damages of any kind arising out of or in any way connected with the Owner's or the dog's presence at, transportation to or from, or participation in any service provided by SMK9, except to the extent such loss is caused by the gross negligence or willful misconduct of a Released Party. Owner further agrees to indemnify and defend the Released Parties against any third-party claim arising from the actions or condition of Owner's dog, including but not limited to bite incidents, property damage, or injury to other dogs or persons.
5. LIMITATION OF LIABILITY
In no event shall the aggregate liability of SMK9 to Owner under this Agreement exceed the fair market replacement value of the dog as determined by reference to comparable animals from a reputable shelter or breeder. SMK9 shall not be liable for special, incidental, or consequential damages (including but not limited to lost wages, lost profits, or loss of use), exemplary, or punitive damages, emotional-distress damages, or loss-of-companionship damages, even if advised of their possibility. This limitation reflects the allocation of risk between the parties and is a material term of this Agreement.
6. GROUP PLAY & GROUP HOUSING CONSENT
SMK9 may, in its discretion, place the dog in group play or group housing with other dogs of compatible size and temperament. Owner understands that group interaction carries inherent risk of minor injury (nicks, scratches) even under careful supervision. Pursuant to Ill. Admin. Code tit. 8, § 25.120(e), group housing requires Owner's prior written consent, recorded by initial below.
Leave blank if you do NOT consent — your dog will be housed and exercised solo.
7. BEHAVIOR MODIFICATION & TRAINING CONSENT
SMK9 specializes in behavior modification for dogs that other facilities have declined or been unable to manage. Owner acknowledges that effective behavior modification may include, where appropriate and at the trainer's discretion: structured leash work, place training, crate work, controlled exposure to triggers, food-motivation protocols, and the use of training tools including flat collars, slip leads, prong collars, e-collars, muzzles, and long lines. Owner consents to the use of such tools as the trainer deems appropriate for the dog's safety and progress. Owner further acknowledges that the success of behavior modification depends substantially on Owner's consistent follow-through at home; SMK9 makes no guarantee of specific behavioral outcomes.
8. PHOTO & MEDIA RELEASE
Owner grants SMK9 the irrevocable right to photograph and video the dog and to use such images in any SMK9 marketing, social media, website, or promotional material, without compensation. Owner's name, address, and personal contact information will not be published. Owner may decline by initialing the "opt out" line below.
9. REFUSAL OR TERMINATION OF SERVICE
SMK9 reserves the right, in its sole discretion, to refuse, suspend, or terminate services for any dog at any time, including but not limited to dogs that exhibit excessive aggression, severe anxiety, contagious illness, excessive barking that constitutes a nuisance under Chicago Municipal Code § 7-12-100, or behavior that endangers staff, other animals, or property. SMK9 also reserves the right to disallow specific breeds where deemed appropriate.
10. CHICAGO BITE-INCIDENT PROTOCOL
If the dog bites a person or another animal at any time during services, Chicago Municipal Code § 7-12-090 requires the owner to (i) notify the Executive Director of the Department of Animal Care and Control within twenty-four (24) hours and (ii) confine the dog under the observation of a licensed veterinarian for ten (10) days, beginning within twenty-four (24) hours of the incident. Owner authorizes SMK9 to report any such incident to Chicago Animal Care and Control on Owner's behalf and, if Owner is unreachable, to arrange the required ten-day observation at a licensed veterinary facility at Owner's expense.
SMK9's reporting on Owner's behalf does not relieve Owner of Owner's independent personal duty to comply with the requirements of MCC § 7-12-090. Owner remains solely and independently responsible for all reporting, confinement, and veterinary observation obligations imposed by applicable law, regardless of any action taken or not taken by SMK9.
11. DANGEROUS-ANIMAL DISCLOSURE
Owner represents that the dog has not been formally designated a "dangerous animal" under Chicago Municipal Code § 7-12-050 or a "vicious dog" under 510 ILCS 5/2.19b, except as disclosed in writing on the intake form. If such a designation exists, Owner must (i) disclose it in writing, (ii) provide a copy of any dangerous-animal license issued under § 7-12-052, and (iii) confirm proof of the $100,000 minimum liability insurance required by the Code. Failure to disclose a dangerous-animal designation is a material breach of this Agreement and grounds for immediate termination of services and forfeiture of any deposit.
12. LATE PICKUP, ABANDONMENT & CANCELLATION
Late pickup: A late-pickup fee equal to one (1) full daycare day will apply for any dog not picked up by the scheduled time. Holiday cancellations made fewer than seven (7) days prior to the reservation forfeit the deposit. Abandonment: If Owner fails to retrieve the dog within thirty (30) days of the stated return date and SMK9 cannot reach Owner or the listed emergency contact, the dog will be deemed abandoned and SMK9 may, pursuant to Ill. Admin. Code tit. 8, § 25.120(f), arrange for the dog to be transferred to a shelter or rescue at Owner's expense.
13. PERSONAL BELONGINGS
SMK9 is not responsible for loss of or damage to leashes, collars, harnesses, blankets, beds, toys, bowls, or other personal items left with the dog. Owner is encouraged to label all items and bring only those items they can afford to lose.
14. DIET & SPECIAL FEEDING
Owner is responsible for supplying sufficient food for the duration of stay unless raw-food service is purchased separately from SMK9. Frozen and refrigerated diets must be clearly labeled and pre-portioned. SMK9 will follow the feeding schedule Owner provides on the intake form to the best of its ability; minor deviation due to dog appetite, stress, or operational schedule shall not constitute a breach of this Agreement.
15. TRANSPORT, RESTRAINT & WASTE REMOVAL
If SMK9 provides home pickup, drop-off, or walk services, Owner authorizes SMK9 staff to enter Owner's residence using the access information Owner provides (key, code, lock-box, or smart-lock credential) for the sole purpose of retrieving or returning the dog. Owner warrants Owner has authority to grant such access and releases SMK9 from any claim arising from alarm activation, lock issues, or building-rule violation, except for damage caused by SMK9's gross negligence. Whenever the dog is outside SMK9's premises, SMK9 will keep the dog under restraint by leash or secure carrier in compliance with Chicago Municipal Code § 7-12-030, and will remove and properly dispose of the dog's waste in compliance with § 7-12-420.
16. SMK9 LICENSURE & REGULATORY COMPLIANCE
SMK9 operates as a licensed Animal Care Facility under Chapter 4-384 of the Chicago Municipal Code and as a licensed kennel/day-care/training facility under the Illinois Animal Welfare Act, 225 ILCS 605, and is subject to inspection by the City of Chicago Department of Business Affairs and Consumer Protection (§ 4-384-130) and the Illinois Department of Agriculture, Bureau of Animal Health and Welfare. SMK9 maintains the sanitation, ventilation, lighting, and general-care standards required by §§ 4-384-050 through 4-384-100 and the staffing or fire-protection certifications required by 225 ILCS 605/3.5.
17. GOVERNING LAW, VENUE & SEVERABILITY
This Agreement is governed by the laws of the State of Illinois without regard to its conflicts-of-law principles. Any dispute arising under this Agreement shall be brought exclusively in the state or federal courts located in Cook County, Illinois. If any provision is held unenforceable, the remaining provisions shall remain in full force and effect. This Agreement constitutes the entire agreement between the parties and supersedes any prior oral or written agreement on the same subject matter.
18. MEDICATION ADMINISTRATION AUTHORIZATION
If Owner requests that SMK9 administer prescription or over-the-counter medication to the dog, Owner must provide: (i) written administration instructions stating the medication name, dose, frequency, and method; (ii) the medication in its original labeled container; and (iii) written veterinary authorization if the medication requires a prescription. SMK9 will make reasonable efforts to administer medication as instructed, but Owner acknowledges that SMK9 is not a licensed veterinary professional and that medication administration may be difficult or impossible due to the dog's behavior, condition, or circumstances beyond SMK9's control. Owner assumes all risk of adverse reaction, injury, missed dose, or administration error arising from good-faith compliance with Owner's instructions and releases SMK9 from all claims arising therefrom. SMK9 reserves the right to decline to administer any medication that it reasonably determines it cannot safely administer.
19. PAYMENT TERMS
Payment in full is due at or before the time of pickup unless SMK9 has agreed in writing to different terms for a specific booking. SMK9 accepts cash (preferred — 5% discount applied), Zelle (3128852243), Venmo (@AlleyCat777), PayPal (@SoundMindK9Chi), CashApp ($ESoto77). A deposit may be required to hold a reservation during peak or holiday periods; the required deposit amount will be communicated at the time of booking. Holiday deposits are non-refundable if the reservation is cancelled fewer than seven (7) days before the scheduled start date, consistent with Section 12 of this Agreement. Any returned, disputed, or reversed payment will result in suspension of services and a $35 returned-payment fee. SMK9 reserves the right to require prepayment from any Owner with an outstanding balance.
20. PER-BOOKING RE-ATTESTATION
This Agreement governs all current and future services provided by SMK9 to Owner. Prior to each subsequent booking confirmation, Owner may be required to confirm that: (i) all information contained in this Agreement and on the intake form remains accurate and complete; (ii) the dog's vaccination records remain current and compliant with the requirements of Section 2; and (iii) Owner's contact and emergency information is up to date. Submission of a booking request or acceptance of a booking confirmation constitutes Owner's re-attestation that all representations and warranties made in this Agreement remain true and accurate as of the booking date. Material changes in the dog's health, behavior, vaccination status, or Owner's contact information must be disclosed to SMK9 in writing prior to drop-off.
A. Owner Information
B. Emergency Contacts
Two emergency contacts required. These individuals may make decisions on the dog's behalf only if Owner cannot be reached.
Contact 1
Contact 2
C. Authorized Pickup Persons
Anyone other than yourself permitted to pick up the dog. Photo ID required at pickup.
D. Dog Information
Required by MCC § 7-12-140 for dogs 4+ months in Chicago.
E. Veterinarian & Vaccinations
Veterinarian of Record
Vaccination Dates
Per Illinois Admin. Code § 25.120(b) and Chicago MCC § 7-12-200.
| Vaccine | Date administered | Expiration |
|---|---|---|
| Rabies | ||
| DHPP | ||
| Bordetella | ||
| Canine Influenza (H3N2) | ||
| Leptospirosis | ||
| Fecal exam (negative) |
F. Behavior & Social History
Honest answers protect your dog and ours. SMK9 specializes in difficult dogs and we take honest disclosure seriously. Hidden bite or aggression history is grounds for immediate termination of services.
Dangerous Animal / Vicious Dog Designation
Has your dog been formally designated as a "dangerous animal" under Chicago MCC § 7-12-050 or "vicious dog" under 510 ILCS 5/2.19b?
Bite History
Check All That Apply
G. Medical, Medications & Diet
Current Medications
Per §18: medications must arrive in original labeled container with written instructions.
Diet
H. Requested Services & Scheduling
Services Requested
Service Rates
| Boarding | $65 / night (1st dog) |
| Transport | $30 / trip |
| Cash discount | 5% off total |
Additional dogs and other service rates confirmed at booking.
Scheduling (if known)
SMK9 is appointment-only. We'll confirm availability after intake.
Preferred Payment Method
Home Access (if SMK9 is providing pickup/drop-off)
Per §15: encrypted at rest. Used only for the purpose of retrieving/returning your dog.
Sign & Submit
I HAVE READ THIS AGREEMENT IN ITS ENTIRETY, I HAVE HAD THE OPPORTUNITY TO ASK QUESTIONS, AND I FULLY UNDERSTAND ITS CONTENTS, INCLUDING THE WAIVER, RELEASE, INDEMNIFICATION, AND LIMITATION OF LIABILITY. I SIGN IT FREELY AND VOLUNTARILY, INTENDING IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF LIABILITY TO THE FULLEST EXTENT PERMITTED BY ILLINOIS LAW. I REPRESENT THAT I AM AT LEAST 18 YEARS OF AGE AND THE LEGAL OWNER OR AUTHORIZED AGENT OF THE DOG IDENTIFIED HEREIN.
Print Name
Owner Signature
Sign in the box below using your finger or stylus.
Thank You
We've emailed a copy of your signed agreement and a summary of the information you provided. Elliott will reach out within 24 hours to confirm your appointment.
What Happens Next
- SMK9 reviews your intake & vaccination records.
- Elliott contacts you to schedule a meet & greet.
- Booking confirmed and services scheduled.
Questions? Email info@soundmindk9.net or call SMK9.
Sound Mind K9 LLC · 3747 W. North Ave., Chicago IL 60647 · Appointment only