Boarding Consent Form

Client Information
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Emergency Contact*
How can you be reached?*

Phone CallTextEmailUnreachable, emergency contact authorized to make treatment decisions
Will someone else be picking up your pet?*

YesNoMaybe
Pick-up Person*

Boarding Check-in
Pet Name*
Drop-off Date*

MonthDayYear
Date
Pick-up Date*

MonthDayYear
Date
Approximate pick-up time?
afternoon, 9am, unknown, etc.
Do you want us to give food and meds before your pet goes home?

Yes, give before pick-upNo, I will give at home
In order to maintain a flea-free environment for the comfort of all the pets staying with us and the homes of their owners, your pet will be checked for fleas and treated, if necessary, with a safe, effective, widely used, EPA approved pesticide.
What flea-prevention do you use?*
Nexgard, Simparica Trio, Bravecto, Revolution, etc.
When was the last dose given?*

MonthDayYear
Date

Personal Belongings
Please accept that Hawthorne Park Animal Care Center cannot be held responsible for the return of all items.
Please provide color and style of the following (if applicable):
Please list any other personal belongings, with a description of each:*
yellow blanket with flowers, pink octopus stuffy, 3 green cloth diapers, etc. Can upload picture of belongings instead, if preferred.

Upload Documents & Photos
Upload any records, if applicable, and include any photos of your pet and their belongings that may be helpful.

We strongly recommend at least uploading a picture of their belongings to help boarding staff identify and return items.
Upload Documents & Photos (optional)

can upload records from other clinics, photos of belongings, etc.
Cancelof