Huebner Oaks Veterinary Hospital: Pre-Boarding Check-In Form

1
Pet Name(s)* This field is required.
Fluffy
2
Pet Parent Name* This field is required.
John Doe
3
Phone Number* This field is required.
Area Code
Phone Number
4
Email* This field is required.
example@example.com
5
Arrival Date & Time* This field is required.Mon - Fri: 7:00am – 6:00pm Sat: 8:00am – 12:00pm Sun: Closed
Date
Month
Day
Year
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
PM
AM
PM
6
Departure Date & Time* This field is required.Mon - Fri: 7:00am – 6:00pm Sat: 8:00am – 12:00pm Sun: Closed
Date
Month
Day
Year
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
PM
AM
PM
7
We are proud to offer spa and pampering options to ensure your pet has the most relaxing stay possible!
8
Spa OptionsCheck all the apply. All spa services are completed on the last day of stay. Please be sure to let us know pick-up time for services. Price determined by weight. Based on availability. Please call to schedule.
Basic Groom: (Bath, Ear Cleaning, Nail Trim, Anal Gland Expression)
Partial Groom: (Bath, Ear Cleaning, Nail Trim, Anal Gland Expression, light scissoring)
Full-Service Groom: (Bath, Ear Cleaning, Nail Trim, Anal Gland Expression, and requested full haircut)
Nail file to smooth edges
Special Shampoo (anti-itch oatmeal shampoo, whitening shampoo, or flea & tick medicated bath)
Deep Conditioning Treatment
De-Shedding Treatment
De-Matting
9
10
Completing annual exams, updating vaccinations and performing other preventative care is highly recommended during boarding stays due to our ability to observe your pet for an extended period of time and the added convenience to you. Would you like your pet to receive any of the following services during their stay:
11
Would you like to add any Recommended Preventive Care?*If Heartworm or Flea Prevention is selected, our staff will contact you to discuss the best options for your pet.
Comprehensive Exam with Complimentary Dental Exam
Canine Flu Vaccine
Canine Lepto Vaccine
Heartworm Test
Heartworm & Flea Prevention
Fecal Screen for Parasites
Blood Work to Assess Kidney & Liver Function
Feline FIV/Leukemia Test
12
How does your pet behave around other pets?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
13
Does your pet have any anxieties or fears like storm anxiety or fear of men or women?* This field is required.
14
Has your pet ever displayed food aggression or toy aggression? Elaborate if needed.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
15
Does your pet walk well on a leash?* This field is required.
YESNO
16
Are there any medical or behavioral concerns you would like us to be aware of that will help make your pets stay more pleasant? Or are there any medical behavioral concerns that we need to keep an eye on?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
17
Does your pet require special care?* This field is required.
18
Please indicate any concerns you may have about your pet that our doctor should be aware of during the Comprehensive Exam:
Huge
Large
Normal
Small
Ok
Ok
19
Would you like to add any Specialty Tests?
Ear Infection Check
UTI Check
Lumps & Bumps Check
20
We are almost done! To confirm your pet receives the right care, please fill out the information on the next page.
21
22
Will you be providing your own food?* This field is required.
YESNO
23
Feeding Instructions Please include amount and frequency.
Huge
Large
Normal
Small
Ok
Ok
24
25
Will your pet require medication during their stay? * This field is required.
YESNO
26
Medication Instructions* This field is required.Please include type, dosage and frequency.
Huge
Large
Normal
Small
Ok
Ok
27
Does your pet have any allergies?* This field is required.Food, seasonal, or other.
YESNO
28
Allergies* This field is required.Please list any allergies and steps to be taken in the event of an emergency.
Huge
Large
Normal
Small
Ok
Ok
29
Vaccination Records Please upload your current vaccination records if they are not already on file.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
30
Anything else you would like us to know?
Huge
Large
Normal
Small
Ok
Ok
31
Pet Parent Signature* This field is required.
Clear
Should be Empty: