Fraser Valley - Boarding Form

CLIENT INFORMATION
Name (Primary Owner)*

First NameLast Name
Reason for Boarding*
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Daytime Phone*
Please enter a valid phone number.
Evening Phone*
Please enter a valid phone number.
Email*
example@example.com
How would you like to be updated during your cat's stay?*

PhoneEmailTextNone
EMERGENCY CONTACT
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
PET INFORMATION
Room Preference*

Penthouse SuiteBachelor SuiteVilla SuiteExecutive SuiteRoyal Suite
Cat's Name*
Date of Birth / Age*
Is your cat spayed or neutered?*

YesNo
Has your cat stayed with us before?*

YesNo
Current flea control being used?*
Note: In order to keep our facility flea free, we will apply a single dose of Advantage for $20 if your cat isn't currently protected
When was it last applied?*

MonthDayYear
Would you like your cat to have a nail trim during their stay?

YesNo
Are all vaccinations up to date?

YesNo
When were the vaccinations last completed?

MonthDayYear
Would you like to have your cat's vaccines updated during their stay?

YesNo
Current Veterinarian/Hospital in case of emergency:
VACCINATION WAIVER

I understand the fact that the doctors and staff have recommended I vaccinate my cat according to 1) the protocol of my family veterinarian OR 2) the protocol at Fraser Valley Animal Hospital. I have elected not to do so and therefore accept all responsibilities of this decision.
Waiver Acknowledgement

I agree to the Vaccination Waiver statement.
Please indicate any current medications for your cat:
Please provide detailed feeding instructions for our staff (type, quantity, frequency, allergies etc.)*
Additional Comments/Services requested:
Requested drop off date:*

MonthDayYear
Date
Requested drop off time (between 10:00am and 4:00pm):*
Requested pick-up date:*

MonthDayYear
Date
Requested pick-up time (between 10:00am and 4:00pm):*
GENERAL INFORMATION WAIVER - Please Read Before Submitting
I understand cats may get sick at any time and that unforeseen conditions may occur while staying at The Cat Nap Inn. I also understand that reasonable efforts will be made to contact me or the emergency contact to explain any treatments required and obtain my instructions regarding them. However, if these efforts are unsuccessful, I authorize the performance of any procedures or treatments which are necessary in the professional opinion of the attending veterinarian.

CAT NAP INN STANDARD WAIVER - Please Read Before Submitting
An examination by the doctor along with medications and/or treatments may be required to maintain the health of your cat. Approximate costs of medications:
- Mirtazapine: $29 - $33 (for inappetence)
- Cisapride: $14 - $20 (for constipation)
- Lactulose: $14 - $20 (for constipation)
- Gabapentin: $15 - $33 (for stress)
- Cerenia: $34.16 - $39 (for vomiting)
- Blood Glucose: $26.86 per collection/test
- Diet Variation: $3 - $6 per can of food
- Assisted Feeding: $20.02 per treatment (if not eating)
- Nail Trim: $23.53
- DOCTOR’S PHYSICAL EXAM: $100.13
Waiver Acknowledgement*

I understand and agree to the General Information and Cat Nap Inn Waiver statements.
CAPTCHA*
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CLIENT INFORMATION

EMERGENCY CONTACT

PET INFORMATION