Pet Boarding Form

Institute of Veterinary Specialists

Cardiology Questionnaire
Client Information
Name*

First NameLast Name
Cell Phone Number*

Area CodePhone Number
Email*
example@example.com
If my pet is receiving medical care while boarding --. IE: annual wellness care, looking at ears, check skin -- I would like the doctor to call me to discuss care during my pet's stay. **If selecting NO, I realize I will not talk with doctor at time of discharge***

YesNo
Emergency Contact
Emergency Contact Name*
Emergency Contact Phone Number*
Pet Information
Pet's Name #1*
Pet's Name #2
Pet's Name #3
Pet's Name #4
Date of Arrival*

MonthDayYear
Date
Arrival Time*

MorningAfternoon/Evening (not available Saturday after 12pm)
Date Picking Up*

MonthDayYear
Date
Pick Up Time*

MorningAfternoon/Evening
**ATTENTION: Boarders who are going home on a Sunday***- Pickup time is at 5:00pm ONLY. *** Sunday pickup should be pre-arranged prior to leaving pet to board, and must be pre-paid at the time of drop off for boarding.

I am not picking my pet up on a Sunday.I am picking my pet up at 5pm on a Sunday.
All pets are feed Hill's Premium dry food diet unless you have brought a special diet.*

Feed TCAH dietWill bring my pet's diet
Name of the food brought to feed while boarding.
Feeding schedule*

Once a dayTwice a day
Amount per feeding*
I would like my pet to have a bath on the day they go home. Pet will be ready to pick up after 12pm*
Yes or No
Medication and dosage to be given while boarding
Please list what items from home- Food, Bedding, Toys, Treats, Other...
Other information to relay to the Animal Care Attendant
What flea control is your pet currently on?*
Date flea control was last given?*
If not on flea control, type NONE
Boarding Animals Together:
Town and Country does not recommend boarding family pets together because:
1. If one of the pets vomits, isn't eating, or is having bowel problems, it is difficult to ascertain which pet is ill.

2. Boarding can be stressful to some animals and can cause pets to fight while in the same kennel --even though they might not fight at home.

3. Boarding can cause pets to get riled up when in the outdoor runs next to other dogs. This can cause dogs in the same household to fight in the outdoor run--even though they do not fight at home.

I understand the reasons that Town and Country does not recommend that pets be boarded together. However, I prefer my pets be boarded together in the same compartment (cat cage, dog cage or run) and release Town and Country from any liability that may result from that decision.
My pets ....

Can not board together!!Can board together indoors/ outdoorsCan only be together outdoorsPlease see my note regarding boarding together below this question.
Please add additional comments we need to know regarding boarding your multiple pets together.
E-Signature --You can use your mobile phone, mouse or touch screen device to sign this document. Click the "Submit: below when finished.*

Clear
Town & Country Animal Hospital
Should be Empty:

Institute of Veterinary Specialists

Client Information

Emergency Contact

Pet Information