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?)
What Food Allergies, or Allergies in general does your dog have?
Amount to be fed each time:
Feeding schedule

Twice Daily (AM/PM)Once Daily ( AM)Once Daily (PM)Other
Other?
Any Medical Conditions we should know about?
Any Behavioral Issues that you are aware of?
Vaccinations

if your dog is not current on vaccinations and you're unable to provide proof, we will administer all required vaccinations. Proof must be provided BEFORE or AT pickup. If you are unable to provide proof of vaccines your pet WILL BE VACCINATED AT YOUR COST.
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
Would you like your pet to have 1 hour of Play? $30.00 each time

MondayTuesdayWednesdayThursdayFridayNone
Would you like your pet to have 30 minutes of additional Playtime? $18.00 each time

MondayTuesdayWednesdayThursdayFridayNone
Would you like your pet to have 20 minutes on 1 on 1 playtime with staff? $15.00 each time

MondayTuesdayWednesdayThursdayFridayNone
Is Your dog pet friendly?

YesNoUnsure
Does your dog shred blankets?

YesNo
Can your dog be trusted off leash? (will it come back if called)

YesNoUnsure, with new people
Does your dog need medication administered? If so, its $9.50 per time to administer medications/supplements. Please list the medication and how often its administered.
Add-on Services $13.50/ day TLC (10 minute private play, session of brushing, AM and PM treat)

MondayTuesdayWednesdayThursdayFridayNo Thank you
$6.00/time Bubble Time

MondayTuesdayWednesdayThursdayFridayNo Thank You
$5.00/time Enrichment Mat

MondayTuesdayWednesdayThursdayFridayNo Thank You
$5.00/day Peanut Butter Kong

MondayTuesdayWednesdayThursdayFridayNo Thank You
$2.50 Daily Picture Taken and Sent to You

MondayTuesdayWednesdayThursdayFridayNo Thank You
$1.50 Bandana

YesNo
$3.00/day Pup-Cup (Whipped cream with Fruit)

MondayTuesdayWednesdayThursdayFridayNo Thank You
$3.00/ day Pup-Sickle (Ice Cream or Vegetable broth)

MondayTuesdayWednesdayThursdayFridayNo Thank You
$6.00/day Puzzle Time (Hunt and Find)

MondayTuesdayWednesdayThursdayFridayNo Thank You
$6.00/day Ball Pit of Fun

MondayTuesdayWednesdayThursdayFridayNo Thank You
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