Boarding Form

Boarding Form
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Emergency contact will be used in case your pet becomes ill and will require immediate medical treatment. We are not a 24 hour facility and will not have a veterinarian on duty after hours or on the weekends after 1pm on Saturday. The emergency contact may be required to pick up your pet and take them to a 24 hour facility for care.
Emergency Contact *

First Name Last Name
Emergency Contact Phone *
Please enter a valid phone number.
Pet's Name *
Breed *
Is your pet allowed to have treats? *

Yes No Other
Does your pet have any food allergies? *
Would you like a bath and nail trim for an additional charge? *

Yes No
I acknowledge that it my pet is not eating to normal standards an easily digestible canned diet will be fed to my pet at an additional charge *

Yes
Is our kennel staff able to play with your pet? *

Yes No
Would you like to receive texts regarding your pet during their stay? *

Yes No
In the event of an unforeseen emergency are we allowed to proceed with extreme life saving measures at an additional expense that you will be responsible for. *

Yes No
Please list any medications that your pet will need: all medications need to be in the original bottle *
If bringing your own food what is it and what is your pets feeding schedule? *
I understand that in cases of emergency, treatment or general care (ie: diarrhea, vomiting, etc) CAC will make a reasonable effort to contact the number provided. However, if no one can be reached, I authorize Chastain Animal Clinic to provide any care deemed necessary by the doctor on duty. I also understand I will be financially responsible for such care.
Signature *

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