UPDATED VACCINATION RECORD SUBMISSION FORM

UPDATED VACCINATION RECORD SUBMISSION FORM

MAGGIE’S DOGGIE CARE
THIS FORM IS FOR EXISTING CLIENTS TO SUBMIT NEWLY UPDATED PROOF OF VACCINATION & VETERINARY RECORDS. IT IS FOR EXISTING CLIENTS WHO HAVE ALREADY COMPLETED & SUBMITTED A CLIENT AGREEMENT. IF YOU HAVE NOT SUBMITTED THE CLIENT AGREEMENT, YOU MUST DO SO FIRST (THIS IS THE WRONG FORM). YOU CAN UPLOAD/ATTACH & SUBMIT YOUR PROOF OF VACCINATIONS THROUGH THE CLIENT AGREEMENT INITIALLY. THEN ONCE THIS IS COMPLETED & SUBMITTED, PLEASE USE THIS FORM TO SUBMIT ANY UPDATED VACCINATION RECORDS IN THE FUTURE AS NEEDED.

PLEASE NOTE: MULTIPLE VACCINATIONS CAN BE SUBMITTED VIA A SINGLE FORM SUBMISSION. MULTIPLE VETERINARY RECORDS/PROOF OF VACCINATION RECORDS CAN BE UPLOADED, ATTACHED & SUBMITTED BELOW IN A SINGLE FORM SUBMISSION. YOU ARE NOT REQUIRED TO SUBMIT A SEPARATE FORM FOR EACH VACCINATION THAT IS LISTED ON THE VETERINARY RECORD. ALL CURRENT VACCINATION RECORDS SHOULD BE INCLUDED IN YOUR SUBMISSION.

THANK YOU!
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Phone Number: *
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E-Mail Address: *
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Veterinary Clinic: *
Primary Veterinarian (if any): *
Veterinary Clinic Address: *

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Veterinary Clinic Phone Number: *
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Veterinary Clinic E-Mail (if any):
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Pet Name(s): *
Date of Visit *

Month Day Year
Date
Additional Visit Dates (if multiple)
VACCINATION REQUIREMENTS

FOR DOGGIE DAY CARE & BOARDING SERVICES

• RABIES

• BORDETELLA (KENNEL COUGH)
ORAL/INTRANASAL OR INJECTION/INTRAMUSCULAR

*ORAL/INTRANASAL BORDETELLA VACCINE HAS A WAITING PERIOD OF 14 DAYS FOR THE VACCINE TO TAKE FULL EFFECT. MUST BE ADMISTERED 15 DAYS PRIOR TO THE START OF ANY SERVICE. INJECTION/INTRAMUSCULAR BORDETELLA VACCINE DOES NOT HAVE ANY WAITING PERIOD. IF YOUR BORDETELLA VACCINE IS EXPIRED & NOT CURRENT, ALWAYS REQUEST THE INJECTION BORDETELLA VACCINE IF YOUR START OF SERVICE DATE IS LESS THAN 2 WEEKS AWAY FROM THE DATE OF ADMINISTRATION.*

• A MINIMUM OF DHPP OR DA2PP

*VACCINE VARIES DEPENDING ON THE VET*

DISTEMPER COMBINATION VACCINE:

- CANINE DISTEMPER ("D")

- HEPATITIS ("H") OR ADENOVIRUS-2 ("A2")

- PARAINFLUENZA ("P")

- PARVOVIRUS ("P, PV, PARVO, -PARVO or +PARVO")

may or may not be included in this vaccine (not required but recommended):

- LEPTOSPIROSIS (STAGNANT WATER) *may be included in the distemper combination vaccine or may be given separately & individually*

- CANINE CORONAVIRUS

PLEASE NOTE: DHLPP-C (all the above for the distemper combination vaccine) are included in the distemper combination vaccine if administered by the South River Veterinary Clinic/Dr. Boulos

VACCINATIONS NOT MANDATORY (but recommended)

• LEPTOSPIROSIS (STAGNANT WATER)

• CANINE CORONAVIRUS

• CANINE INFLUENZA (DOG FLU - H3N8 & H3N2)

• LYME (LYME'S DISEASE)
Updated vaccination record submission for the following vaccines (select all that apply): *

Rabies (1 YEAR) Rabies (3 YEAR) Bordetella (Kennel Cough) • ORAL/INTRANASAL *14 day waiting period for the vaccine to take full effect after administered* Bordetella (Kennel Cough) • INJECTION/INTRAMUSCULAR *no waiting period* Canine Distemper (“D”) Hepatitis (“H”) or Adenovirus-2 (“A2”) Parainfluenza (“P”) Parvovirus (“P, PV, Parvo, -Parvo or +Parvo”) Leptospirosis (Stagnant Water • “L, -L, Lepto, -Lepto, 4L or +4L” • may be included in your distemper combination vaccine or may be given separately depending on which vaccine your vet uses) Canine Coronavirus (“C or -C” • may or may not be included in your distemper combination vaccine depending on which vaccine your vet uses) Canine Influenza (Dog Flu • H3N8 & H3N2 • “Canine Influenza, K9 Influenza, CI or CIV”) Lyme (Lyme’s Disease • Ticks)
ADDITIONAL INFO (if any):
MANDATORY CLIENT VACCINATION REQUIREMENTS

Client is responsible for ensuring that the client's pet is current and up to date on all of the mandatory vaccination requirements for doggie day care and boarding services at Maggie's Doggie Care. The mandatory vaccination requirements for doggie day care and boarding services are: Rabies, Bordetella (Kennel Cough) and a minimum of DHPP or DA2PP, which includes Distemper, Hepatitis or Adenovirus-2, Parainfluenza and Parvovirus. Leptospirosis (Stagnant Water), Coronavirus, Canine Influenza (Dog Flu) and Lyme (Lyme's Disease) are not a mandatory vaccination requirement, however, they are highly recommended. Client shall submit any up to date and current vaccination records to Maggie's Doggie Care as they are received and as they are updated after expiration.

VACCINATION RECORD SUBMISSION

Proof of vaccination is a mandatory requirement and must be in the form of an official veterinary record from the veterinary clinic and/or veterinarian. Please upload your newly updated vaccination and veterinary records in the file upload section provided below.

FILE UPLOAD OF THE VACCINATION & VETERINARY RECORDS IS REQUIRED
File Upload: *

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I, THE CLIENT/PET OWNER, AUTHORIZE THE TRANSFER AND SUBMISSION OF THE FOLLOWING VACCINATION AND VETERINARY RECORDS TO MAGGIE'S DOGGIE CARE/MAGGIE MCSPADDEN. I ACKNOWLEDGE AND AGREE TO THE MANDATORY VACCINATION POLICY REQUIREMENTS OF MAGGIE'S DOGGIE (PLEASE SEE THE CLIENT AGREEMENT FOR VACCINATION POLICY DETAILS).
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