Exclusively Cats Boarding Request Form

Exclusively Cats Boarding Request Form

Please complete this form for submission for boarding at Exclusively Cats Medical Center of Medford at 4 Chester Ave, Medford, NJ 08355
Contact Information

Please note, if you are a current EC Medford client, this will be used to confirm for our records.
Your Name

First NameLast Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Booking Information
Will this be general boarding or medical boarding?

General BoardingMedical Boarding
Check In Date

MonthDayYear
Date
Check Out Date

MonthDayYear
Date
How many cats are you boarding with us?
Size of condo requested
Do you have a preferred theme?
Your Cat's Details
Your Cat(s)*
Veterinarian Details

Please fill out information if you are not a current client of Exclusively Cats Medical Center of Medford. If you are a current client, leave blank.
Name of Veterinary Practice:
Phone Number
Please enter a valid phone number.
Email
example@example.com
Health Details
Up to date with all vaccinations?

YesNo
Please provide a vaccination certificate. (Please note if you are a current EC Medford client, please skip this step)

Cancelof
Any medical conditions or recent injuries or illnesses?
Any allergies or food sensitivities?
Would you like us to apply flea/tick control while your pet is here? (Charges will apply)

YesNo
Please note, if live ticks are seen on your pet, flea/tick control will be applied at the expense of the owner.
We provide bedding and bowls. If you wish to bring bedding from home, realize that it may be damaged or soiled by your pet. Bedding may get lost during laudnering but we will do our best to return all belongings to you. We are not responsible for lost or damaged personal items.
Food will not be provided by the hospital, please let us know what type of food your cat eats; include the brand if possible.
How many times a day do they usually eat?

MorningMid-dayNightFree feed (always keep food in their bowl)
Approximately how much food do they get at each feeding:
Are there any special feeding instructions?
Are they allowed treats?

YesNo
If your pet declines food, we have snacks and treats to entice them to eat. May we use these if necessary?

YesNo
When your pet is stressed, nervous, or anxious, what helps them feel more relaxed and calm?
We will be happy to send you daily pictures and/or videos updates unless you choose otherwise. Would you like to receive these updates at no additional charge?

YesNo
Best update address (mobile number or email)
Any additional notes about your cats that you would like to share?
EMERGENCY CONTACT/AUTHORIZATION INFORMATION

If your pet develops minor ailments while in our care, every attempt will be made to reach the owner or guardian. If unable to reach owner or guardian, and your pet requires urgent or emergent care, our doctors and staff will perform diagnostics, medical and/or surgical procedures, or treatments to preserve the life or comfort of your pet. Owner will accept financial responsiblities for such care. We do not guarantee a successful outcome.
By checking this box, you accept financial responsibility for diagnostic work-up and/or treatment as recommended by the veterinarian in the event that the urgent/emergent care is needed.*

Yes
Please include the name and phone number of an alternative contact should we be unable to reach you:

First NameLast Name
Phone Number
Please enter a valid phone number.
Please note submission of this form is an inquiry only. THIS IS NOT FINAL CONFIRMATION. You will be contacted by a member of the Exclusively Cats staff to confirm your cats stay.
By checking this box I agree that this is not a confirmation and will be contacted by a member of the Exclusively Cats Medical Center of Medford team to confirm my reservation*

Yes
Should be Empty:

Exclusively Cats Boarding Request Form

Contact Information

Booking Information

Your Cat's Details

Veterinarian Details

Health Details

Please note submission of this form is an inquiry only. THIS IS NOT FINAL CONFIRMATION. You will be contacted by a member of the Exclusively Cats staff to confirm your cats stay.