K-9 Boarding Form

K-9 Boarding Form
K-9 Boarding Consent Form

This form is only for CONFIRMED boarding reservations. If you do not have a confirmed reservation, please call the clinic to book a reservation.
Name

First NameLast Name
Email
example@example.com
Dog's Name(s)
Phone Number
Please enter a valid phone number.
Dates your dog will be staying with us
Drop-off date

MonthDayYear
Date
Pick-up date

MonthDayYear
Date
Emergency Contact Name
Emergency Number
Diet

Belmont's Food ($2.50 per feeding)Own food ( pre-packaged for each feeding)Separate Pets for Feeding ($10.00 each time)Food Allergies (if yes, then what?)
Amount to be fed each time:
Feeding schedule

Twice Daily (AM/PM)Once Daily ( AM)Once Daily (PM)Other
Vaccinations

if your dog is not current on vaccinations and you're unable to provide proof, we will administer all required vaccinations.
Proof Of Vacciation

Proof of current vaccinations from Belmont Veterinary CenterProof of current vaccinations from another hospital
Your dog must be free of internal and external parasites including fleas and ticks. If your pet is not free of these, we will administer preventatives at your expense. Client Initials
Should my pet (s) become ill, a Belmont Veterinary Center veterinarian will provide all medical surgical treatment deemed necessary in the doctor's professional judgement. I acknowledge that in the event of my pet's illness, the staff may not be able to contact me immediately and therefore authorized to initiate appropriate treatment until I can be reached. I agree to pay all related expenses associated with treatment of my pet until I am available to discuss further care and related fees with the attending veterinarian Client Initials
IMPORTANT: If my dog has a serious illness or injury, and in the event such as illness or injury becomes critical during my absence, I want the doctors and medical team of Belmont Veterinary Center to:*

Resuscitate my dogDO NOT Resuscitate my dog
Owners signature

Clear
Boarding
Do you want your want your dog to play with others? (we only let out pet friendly dogs to play together. However, there are risks to social play and if your pet becomes injured, you are responsible for treatment)

YesNo
Is Your dog pet friendly?

YesNoUnsure
Does your dog shred blankets?

YesNo
Extra Playtime Options

1 hour of Play $30.00 ____# of days30 minutes of play $18.00 ____ # of days20 minute 1-1 w/staff $15.00 ____ # of days
Does your dog need medication administered? If so, its $9.50 per dose to administer medications/supplements. Please list the medication and how often its administered.
Add-Ons

$13.50/day-TLC add on- Includes 10 min private play session each day, brushing for a shiny coat, morning and afternoon treat ____ # of days$6.00- Bubble time ____ # of days$5.00-Enrichment Mat ____ # of days$5.00- Peanut Butter Kong ____ # of days$2.50- Daily picture update ____ # of days$1.50 - Bandana$3.00-Pup Cup (whipped cream) ____ # of times$3.00-Pup-sickle (ice cream or broth) ____# of times$6.00- Puzzle time/Hunt & Find ____ # of times$6.00- Ball Pit of Fun ____ # of times
Other Services- We can provide a variety of services while your dog stays with us at your request. Please check the services you need.

Comprehensive physical exam and appropriate vaccinationsProfessional Dental CleaningWellness blood test (checks all vital organs for health or signs of disease)Nail TrimHeartworm CheckFecal test to screen for parasitesSurgical ProcedureBathing ServiceMicrochipDental EstimateOther
Signature

Clear
Should be Empty:

K-9 Boarding Form

K-9 Boarding Consent Form

Vaccinations

Boarding