Boarding Check-In Form

1
Enter Your Information So We Can Fetch Your Account* This field is required.PLEASE ENTER THE INFORMATION ASSOCIATED WITH THE ACCOUNT WE HAVE ON FILE.
First Name
Last Name
Phone Number
Email Address
2
Who Is Coming For A Visit?* This field is required.Please enter only one pet's name
Pet Name
3
When Should We Expect You?* This field is required.Drop-off/Pick-up Window: Monday through Friday, 8:00 AM to 6:00 PM Please Note: SBAH is unable to accommodate drop-offs or pick-ups on holidays.
Date
Month
Day
Year
4
Drop-off TimeNo need to provide an exact arrival time—an estimate is perfectly fine! This helps us prepare for your pet's arrival and make their check-in as smooth as possible.
Enter the approximate time for drop-off.
5
Boarding fees begin on the day of your pet's arrival. On the day of departure, pets picked up before 12:00 PM will not incur boarding charges for that day. Pets picked up after 12:00 PM will be charged for a full day of boarding.* This field is required.
I have reviewed and understand the boarding fee policy. I acknowledge that if my pet is picked up after 12:00 PM on the day of departure, I will be charged for a full day of boarding.
6
When Will You Be Picking Up Your Pet?* This field is required.Drop-off/Pick-up Window: Monday through Friday, 8:00 AM to 6:00 PM Please Note: SBAH is unable to accommodate drop-offs or pick-ups on holidays.
Date
Month
Day
Year
7
Pick-Up TimeWe do not need an exact time, just a rough estimate, so we can make sure everything is ready to go before your arrival.
Enter the approximate time for pick-off.
8
To help keep all of our boarding guests happy and healthy, pets must be current on the vaccinations listed below prior to their stay. * This field is required.Vaccines Required For Dogs: DAPP, Lepto, Bordetella, Influenza Bivalent, and Rabies Vaccines Required For Cats: FVRCP and Rabies If your pet is not currently up to date, no worries! We can administer any needed vaccines when your pet is dropped off. If your pet has received vaccines from another facility, please email us the updated vaccination records before check-in at reception@shadybrookvet.com
I have reviewed the required vaccination requirements for my pet, and I am aware my pet must be current on the vaccines that are required for my pet to stay at SBAH.
9
I authorize the staff of Shady Brook Animal Hospital to administer any required vaccinations and any additional treatments, medications, or services that I have requested for my pet during their stay.* This field is required.
I agree and consent.
10
Emergency Contact* This field is required.We will always keep you informed regarding any updates about your pet(s), including their status and any potential evacuations or emergency situations. Please note that we require a designated emergency contact for your pet in the event of an emergency and/or evacuation. This contact must be local and available to promptly pick up your pet if necessary.
Emergency Contact Name
Emergency Contact Phone Number
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Health Concern Authorization* This field is required.While uncommon, pets may occasionally develop minor health concerns or signs of discomfort during their stay. If we observe any changes in your pet's condition that are not considered life-threatening, we will make every effort to contact you to provide an update and discuss our recommendations. Examples may include gastrointestinal upset, changes in appetite, vomiting, ear irritation, or other concerns that may benefit from medical attention. If we are unable to reach you or your emergency contact, how would you like us to proceed?
APPROVAL TO PROCEED AS MEDICALLY NECESSARY: I understand that the SBAH team will make every reasonable effort to contact me and my designated emergency contact regarding my pet's condition and any recommended care. If neither I nor my emergency contact can be reached, I authorize the veterinarian to provide any treatments, medications, diagnostics, or supportive care deemed medically necessary for my pet's health, comfort, and well-being. I understand that I am financially responsible to pay in full on the day of checkout for any additional services, treatments, medications, or related costs incurred during my pet's boarding stay.
APPROVAL UP TO A CERTAIN AMOUNT: I understand that the SBAH team will make every reasonable effort to contact me and my designated emergency contact regarding my pet's condition and any recommended care. If neither I nor my emergency contact can be reached, I authorize the veterinarian to provide any treatments, medications, diagnostics, or supportive care deemed medically necessary for my pet's health, comfort, and well-being. I understand that I am financially responsible to pay in full on the day of checkout for any additional services, treatments, medications, or related costs incurred during my pet's boarding stay.
DO NOT PROCEED: I understand that the SBAH team will make every reasonable effort to contact me and my designated emergency contact regarding my pet's condition and any recommended care. If neither I nor my emergency contact can be reached, I DO NOT AUTHORIZE any treatments, medications, diagnostics, or supportive care completed for my pet. I understand that the SBAH will not be authorized to provide care for my pet until either I or my designated emergency contact authorizes them to do so.
12
CPR/DNR Status* This field is required.As a precaution, any pet that stays in our hospital is required to have a CPR/DNR status. In the event of an unexpected cardiac or respiratory emergency, do you give consent for resuscitation efforts to be initiated until you can be contacted further and notified of their status? By consenting to this service, you are also acknowledging that certain fees will apply (that can range from $200 to $400) in addition to the charges for the services rendered from your pet's boarding stay.
I agree to CPR being performed in case of arrest.
I elect a "Do Not Resuscitate" status in case of arrest.
13
Will your pet need our staff to give any medications to them during their stay?* This field is required.Please Note: There will be an additional $4.00 fee per frequency per day for pets needing medications
YESNO
14
Please list the medication, the amount to be given, and the frequency your pet should be given this/these medication(s).
Name of Medication
Amount To Be Given
Frequency
Medication #1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Medication #2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Medication #3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Medication #4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Medication #1
Medication #2
Medication #3
Medication #4
Name of Medication
Row 0, Column 0
Amount To Be Given
Row 0, Column 1
Frequency
Row 0, Column 2
Name of Medication
Row 1, Column 0
Amount To Be Given
Row 1, Column 1
Frequency
Row 1, Column 2
Name of Medication
Row 2, Column 0
Amount To Be Given
Row 2, Column 1
Frequency
Row 2, Column 2
Name of Medication
Row 3, Column 0
Amount To Be Given
Row 3, Column 1
Frequency
Row 3, Column 2
1 of 4
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Please explain anything additional for your pet's medication.Let us know what tricks of the trade you know (i.e., any preferences your pet has for medication administration.)
16
Will you be bringing food for your pet?* This field is required.It's completely your choice! Many pets do best when they stay on their regular diet, so you're welcome to bring food from home. If you prefer not to, we are happy to provide Purina EN dry kibble at no additional charge during your pet's stay.
YESNO
17
May we provide Purina EN if your pet runs out of food or gets an upset tummy?* This field is required.We are happy to provide Purina EN dry kibble at no additional charge during your pet's stay. If your pet prefers or requires Purina EN canned food, an additional fee will be added to your final invoice.
YESNO
18
How much do you feed per feeding?* This field is required.Please enter food amounts using actual measuring cup amounts (such as ½ cup, 1 cup, or 1½ cups). "One cup" can mean different things to different people—a solo cup and a measuring cup are very different sizes! Providing exact amounts helps us keep your pet's feeding routine consistent during their stay.
19
How often is your pet fed daily?* This field is required.
Please Select
Please Select
1
2
3
Free Feed (food is left in the bowl for my pet to graze on)
20
Does your pet have any food allergies?* This field is required.
YESNO
21
Please explain your pet's allergy:
22
Would you like to add playtimes for your pet?* This field is required.Canines: All canine guests enjoy outdoor potty breaks at least three times daily to "take care of business." For pets who would enjoy some extra time outside their room, we also offer additional one-on-one playtimes with our team. Whether you have a young pup looking to burn off some energy or a senior pet who enjoys a little extra sunshine and attention, these sessions provide additional enrichment, exercise, and personalized care during their stay. Felines: We haven't forgotten about our feline guests! For cats who enjoy a little extra attention during their stay, we offer one-on-one playtime sessions with our team. Whether your cat loves chasing a feather wand, batting at toys, or simply enjoying some extra pets and brushing, we'll tailor the experience to their personality and preferences to help make their stay even more enjoyable. Additional Playtime: $11.00 per session
YESNO
23
When would you like your pet to receive playtimes?
AM
PM
AM AND PM
24
Would you like your pet to receive a bath before going home?* This field is required.Sorry, to our kitty owners- this is a canine-only service. Kitties strongly disapprove of bath time. If you are a cat owner, please select 'No'.
YESNO
25
Please Review The Options Below:
26
Which bath package would you like for your pet?
Regular
Deluxe
FURminator©
Anal Gland Expression ONLY
Nail Trim ONLY
27
If fleas or ticks are identified on your pet during their visit, treatment will be administered to prevent the spread of parasites within the hospital. Additional charges will apply for this service.* This field is required.
I understand and agree.
28
"Overnight Bags"* This field is required.You are welcome to bring any of your pet's belongings with them for their stay. We do provide bedding, water bowls, and food bowls if you choose not to. We do not allow pets to wear any clothing or collars while they are in their room for safety precautions. Please keep in mind, while a pet is out of their home and in an environment that is not their own, they may choose to act out a little and chew or destroy items they normally do not chew or destroy. While we strive to provide a safe environment for every pet, Shady Brook Animal Hospital cannot assume responsibility for damage to personal belongings or for any illness or injury that may occur if a pet ingests items brought from home.
I have read the policy in regard to SBAH's left-behind pet belongings. I agree with and understand the above information.
29
Photo Release* This field is required.We love taking photos of your furry friends while they are staying with us. Typically, we only send them to the owner of the pet with little update on how their pet is doing during their stay. However, if we do happen to capture a photo that we think other pet lovers will enjoy just as much as you do, do you give us permission to share this photo? We will never include sensitive or personal information. Please select the option that you are most comfortable with.
Yes, I consent for photos to be taken AND SHARED OF MY PET.
Yes, I consent for photos to be taken; however, I ONLY APPROVE OF THEM BEING SENT TO ME
No, please do not take any photos. I understand this means I will also not receive photos of my pet during their stay.
30
If I neglect to pick up my pet within 5 days of my scheduled pick-up date and do not notify Shady Brook Animal Hospital within that time frame, Shady Brook Animal Hospital may assume my pet is abandoned and take the appropriate required measurements.* This field is required.
I have read and agree
31
Boarding Consent and Release Form

REQUIRED NOTICE: LACK OF FIRE SUPPRESSION AND OVERNIGHT STAFFING

Compliance with HB 2063
Shady Brook Animal Hospital, as is allowed by Texas law, is not equipped with an on-site fire suppression sprinkler system and does not employ on-site personnel during the hours of Monday- Friday 6:00 PM- 7:30 AM, Saturday and Sunday 9:00 AM-4:00 PM and 5:00 PM-8:00 AM. All animals boarded at the Facility will be left unattended during those times.

OWNER CONSENT AND RELEASE FOR DOG OR CAT TO BE LEFT

I, the undersigned client, hereby give my consent for my pet named above to be boarded at the Facility on the following dates that are listed at the top of my boarding consent paperwork for the facility. I acknowledge that I have received and read the Facility’s notice on its lack of fire suppression and overnight staffing. I understand and acknowledge that the Facility is not equipped with an on-site fire suppression sprinkler system. I further understand and acknowledge that the Facility is unstaffed between the hours specified in the notice and that my pet will be unattended during those times during their boarding stay. By signing this consent form, I agree to release the Facility, its owners, employees and agents from any and all liabilities, claims or expenses arising from my pet’s boarding stay, including but not limited to injuries, illnesses or death. I have read and understood the statements outlined in the notice and in this consent form and release. I voluntarily consent to my pet staying at the Facility and acknowledge that I am solely responsible for any consequences that might arise during their stay.
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Compliance with HB 2063* This field is required.Owner Information
First Name
Last Name
Address
Phone Number
Email Address
33
Compliance with HB 2063* This field is required.Pet Information
Pet Name
Breed
Age
Weight
34
Compliance with HB 2063* This field is required.Veterinary Information
Veterinarian
Veterinary Facility Phone Number
Veterinary Facility Address
35
Date* This field is required.
Date
Month
Day
Year
36
Signature* This field is required.
Should be Empty: