Northwest Veterinary Hospital - Boarding Form
Please fill out one form per pet. Do not fill out more than 7 days prior to your pet's drop off.
Due to COVID, we are not allowing clients in our facility. All clients must wear masks when interacting with staff. Upon arrival, please call the clinic and remain in your vehicle until a staff member waves at you to step outside. All pets must arrive on leashes or in carriers. Thank you for helping us keep our staff and their families safe.
Name
*
First Name
Last Name
Pet's Name
*
Has your pet been seen at Northwest Vet for boarding or examinations previously?
*
No.
Yes.
Have your brought any other pets to see us for boarding or examinations?
*
No
Yes
I will be bringing my pet to Northwest Veterinary Hospital
*
for boarding only
for boarding and veterinary care
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
-
Area Code
Phone Number
Home Phone Number
-
Area Code
Phone Number
Work Phone Number
-
Area Code
Phone Number
Email
example@example.com
Co-owner's name
Relationship to co-owner
*
Spouse
Significant other
Family
Friend
Co-owner phone
*
-
Area Code
Phone Number
How did you find us?
*
Website
Internet search
Referred by friend / family
Another veterinary office or business
Which website?
*
What search term did you use?
*
Name (so we can send them a thank you and clinic credit to use toward their next visit)
*
Name of veterinary office or business
*
Pet's birth date or age
*
Species
*
Cat
Dog
Breed(s)
*
Color(s) / Marking(s)
*
Sex
*
Female
Male
Uncertain
Spayed or neutered
*
Yes
No
Uncertain
Would you like information on spaying or neutering your pet?
*
Yes
No - I plan on spaying / neutering my pet at another facility
No - I do not intend on spaying / neutering my pet and am aware of the serious health and behavior risks
It's important for us to obtain your pet's medical history prior to their visit. We are happy to reach out to their previous or current veterinary office(s).
Please provide us with the following if you have not done so already
Veterinary office name
City and state
Veterinary office phone number (if available)
-
Area Code
Phone Number
Pet first and last name (if different than names provided)
If your pet has received vaccines or had a fecal test performed (dogs only) since their last visit at Northwest Vet, you can upload records here.
Browse Files
For dogs: proof of fecal tests (intestinal parasite exams) must include test result to be valid
Cancel
of
Best contact number for you while your pet stays with us
*
-
Area Code
Phone Number
Alternative Contact Name
Alternative Contact Phone Number
Pick up and Drop off Hours:
Mondays 8:30a-7:30p, Tues-Fri 8:30a-5:30p, Sat 8a-12:30p // Closed Sundays // Closed Memorial Day, 4th of July, Labor Day, Thanksgiving, Christmas, New Year's Day
Drop Off Date
*
-
Month
-
Day
Year
Date
Approximate Drop Off time
*
Pick Up Date
*
-
Month
-
Day
Year
Date
Approximate Pick Up Time
*
*Please note: If requesting a bath the day of pick up, pick up no earlier than 2p on weekdays; between 12-12:30p on Saturdays.
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Does your pet have any medical conditions we should be aware of?
*
Yes
No
Please describe
Has your pet been ill or injured in the past 2 weeks? Any medical concerns?
*
Yes (If your pet is displaying any signs of upper respiratory infection, including coughing or sneezing, please contact the office @ 512-453-7776)
No
Please describe
*
Food and Medications
If your pet has dietary restrictions or is sensitive to diet changes, be sure to bring their diet from home.
Will you be bringing your pet's diet?
*
Yes
No. Please use clinic diet (we'll calculate amounts to feed based on your pet's weight).
Name of Diet
*
Amount to feed per meal (in cups, cans or baggies)
*
It's always helpful if you bring the amount of food you anticipate your pet will need while staying with us instead of large bags or containers
Frequency of feeding
*
1 meal in AM
1 meal in PM
2 meals / daily
Other Feeding Instructions
Does your pet need medication or supplements administered while boarding?
*
Yes
No
Medications to be given (please include names, mg of medication, amount to be given, frequency, and any other special instructions).
*
Please note: There is an additional fee for medicating your pet while boarding. Please bring all medications in original containers.
Is there anything else you'd like us to know to improve your pet's boarding experience?
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Services
Select any services you would like us to perform during your pet's visit
Bath $22-$28 (dogs only)
Nail Trim $15.30
Anal Gland Expression $32
General Exam $73 (prices vary for recheck exams and routine wellness exams with vaccinations)
Annual Comprehensive Lab Work $173
Please fill out a pre-exam form
https://form.jotform.com/201736687727164
When would you like us to bathe your pet?
*
Day before pick up
Day of pick up (pick up after weekdays, between 12-12:30p Saturdays)
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Privacy and medical records release
Section 801.353 of the Texas Veterinary Licensing Act protects your privacy by prohibiting disclosure of your pet(s) health care records (including rabies and other immunizations) without our specific authorization.
I give Northwest Veterinary Hospital permission to release information concerning the veterinary care for my pet(s):
*
Yes
No
I give Northwest Veterinary Hospital permission to use my pet(s) names and pictures for display, public relations and marketing.
*
Yes
No
I have have read and accept all terms on this page
*
Clear
Print Name
*
Have you, your pet or anyone in your household displayed any symptoms of COVID-19 / flu, tested positive or been in contact with anyone who has tested positive for COVID-19 / flu in last 2 weeks?
*
No
Yes - Contact hospital
To help us maintain a low risk facility, masks are required when our team transports your pets to and from your vehicle or has brief socially distant conversations.
*
I understand and will wear a mask when interacting with staff in my car / in the parking lot.
Thank you for letting us care for your pet! Don't hesitate to reach out with any questions or concerns @ 512-453-7776 clientcare@nwvhaustin.com
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