Boarding Admit Form
Happy Days & Sleepy Nights
Name
*
First Name
Last Name
Pet's Name
*
Email
*
example@example.com
Emergency Contact Number
*
-
Area Code
Phone Number
Emergency Contact Name
*
First Name
Last Name
Diet While Staying With Us
*
Hospital Food
Bringing Own Food
What is your pet eating while boarding
How Much Food and How Often?
*
1 Cup Once a Day or 1 Cup Twice a Day, ect.
If Bringing Own Food, What Brand of Food?
Blue Buffalo, Iams, etc
Medications
Bath/Nail Trim Before Going Home
*
None
Bath & Complimentary Nail Trim ($43-$60)
Nail trim only ($12.50)
Are you bringing any belongings? (Mundelein Animal Hospital is not responsible for items brought into the hospital)
(bed, blanket, food treats)
A La Carte Menu Items are Additional Charge for Dogs and Cats
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Frozen Peanut Butter Kong (Dog)
A kong filled with frozen peanut butter and a Milk Bone inside
$
4.00
Quantity
1
2
3
4
5
6
7
8
9
10
Romps (Dog)
Your pet will be let outside with a kennel technician to run around our outside area for 15 minutes
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Fresh Air Stroll (Dog)
Will be given an extra walk
$
8.00
Quantity
1
2
3
4
5
6
7
8
9
10
Treat/Food Ball (Cat)
A little food ball that has treats in it. As they play around with the treat ball, treats come out of the little holes
$
4.00
Quantity
1
2
3
4
5
6
7
8
9
10
Swing and Swat (Cat)
Provide your kitty with an afternoon interactive catnip toy to encourage mental and physical challenges. (will be sent home with each guest)
$
4.00
Quantity
1
2
3
4
5
6
7
8
9
10
Purring Play time (Cat)
15 minutes of time outside of their suite with a kennel technician for enrichment activities
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Additional Notes You Would Like Our Hospital/Kennel Staff to Be Aware Of/Know
All animals must be current on vaccinations, yearly negative fecal exam, and free of internal & external parasites or they will be TREATED at Mundelein Animal Hospital (MAH) AT MY OWN EXPENSE. I authorize MAH to do whatever is necessary should an emergency arise. Should my pet become ill or injure itself, and MAH IS UNABLE TO CONTACT MY ER CONTACT (at the number I have provided above) it will be treated at my own expense. MAH is not responsible for ANY belongings brought and left with my pet. MAH recommends a bath at the end of the stay, but it is my option and at my cost. Unclaimed pets after the date which is stated as a pick-up date, I understand that written notice will be mailed to my last address as given. 7 days after such written notice the pet(s) will be considered abandoned and may be disposed of, or destroyed, as deemed best. This WILL NOT relieve me from any debt owed to the MAH. ALL ABOVE INFORMATION IS ALSO CORRECT (IE food, medications, contact numbers, due vaccinations, etc) This form and signature will be kept on file and current for no more than 1 year.
*
Initials
Signature
*
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